超声引导下喉上神经阻滞在无痛纤维支气管镜中的应用效果及对应激反应、不良事件的影响  

Application effect of ultrasound-guided superior laryngeal nerve block in painless fiberoptic bronchoscopy and its influences on stress response and adverse events

作　　者：刘昊 李晓报 LIU Hao;LI Xiaobao(the People's Hospital of Yanchang County,Yan'an 717199;the People's Hospital of Zichang,Yan'an 717300,China)

机构地区：[1]延长县人民医院,陕西延安717199 [2]子长市人民医院,陕西延安717300

出　　处：《临床医学研究与实践》2025年第12期78-81,共4页Clinical Research and Practice

摘　　要：目的探讨超声引导下喉上神经阻滞在无痛纤维支气管镜中的应用效果及对应激反应、不良事件的影响。方法选取2021年12月至2023年12月于本院诊治的50例行纤维支气管镜检查患者为研究对象。按照随机抽签法将其分为对照组和观察组,每组25例。对照组采用气道表面局部麻醉,观察组采用超声引导下喉上神经阻滞。比较两组的生命体征、镇静评分、应激反应、镜检时间、麻醉起效时间及不良事件发生情况。结果纤维支气管镜进入声门时(T_(2))~检查结束后15 min(T_(5)),观察组的心率(HR)、平均动脉压(MAP)低于对照组,差异具有统计学意义(P<0.05);T_(2)~检查完成即刻(T_(4)),观察组的警觉与镇静评分(OAA/S)评分低于对照组,差异具有统计学意义(P<0.05)。T_(4),两组的醛固酮(ALD)、促肾上腺皮质激素(ACTH)、皮质醇(Cor)水平均升高,但观察组低于对照组,差异具有统计学意义(P<0.05)。观察组的镜检时间、麻醉起效时间短于对照组,差异具有统计学意义(P<0.05)。观察组的不良事件总发生率低于对照组(P<0.05)。结论超声引导下喉上神经阻滞用于无痛纤维支气管镜检查可获得良好的临床效果,安全性较高,可进一步在临床中推广。Objective To explore the application effect of ultrasound-guided superior laryngeal nerve block in painless fiberoptic fiberoptic bronchoscopy and its influences on stress response and adverse events.Methods A total of 50 patients who underwent fiberoptic bronchoscopy in our hospital from December 2021 to December 2023 were selected as the research objects.According to the random lottery method,the patients were divided into control group and observation group,with 25 cases in each group.The control group received local anesthesia on the surface of the airway,and the observation group received ultrasound-guided superior laryngeal nerve block.The vital signs,sedation score,stress response,microscopic examination time,anesthesia onset time and adverse events were compared between the two groups.Results From fiberoptic bronchoscopy entered the glottis(T_(2))to 15 min after the end of the examination(T_(5)),the heart rate(HR)and mean arterial pressure(MAP)of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05);from T_(2) to immediate completion of the inspection(T_(4)),the Observer's Assessment of Alertness/Sedation(OAA/S)score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).At T_(4),the levels of aldosterone(ALD),adrenocorticotropic hormone(ACTH)and cortisol(Cor)in the two groups increased,but those in the observation group were lower than the control group,and the differences were statistically significant(P<0.05).The microscopic examination time and anesthesia onset time of the observation group were shorter than those of the control group,and the differences were statistically significant(P<0.05).The total incidence of adverse events in the observation group was lower than that in the control group(P<0.05).Conclusion Ultrasound-guided superior laryngeal nerve block for painless fiberoptic bronchoscopy can obtain good clinical effect and has high safety,which can be furt

关 键 词：超声引导 喉上神经阻滞 无痛纤维支气管镜 

分 类 号：R614[医药卫生—麻醉学]