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纤维支气管镜检查中麻醉方法的改良研究
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| 篇名： | 纤维支气管镜检查中麻醉方法的改良研究 |
| TITLE： | |
| 摘要： | 目的：比较3种纤维支气管镜（以下简称“支气管镜”）麻醉方法的麻醉效果，探讨支气管镜检查的麻醉改良方法。方法：315例拟行支气管镜检查的患者采用随机数字表法分为A组（106例）、B组（104例）、C组（105例）。A组患者采用传统支气管镜雾化利多卡因局麻的方法，B组患者采用哌替啶联合雾化利多卡因的改良支气管镜雾化局麻法，C组患者采用三通连接管连接喉罩及靶控丙泊酚与瑞芬太尼全麻的改良无痛支气管镜检查法。比较3组患者检查前与检查中的血氧饱和度（SaO2）、收缩压（SBP）、舒张压（DBP）、心率、呼吸频率、麻醉优良率、依从率、体动呛咳率和痛苦记忆率，并观察不良反应发生情况。结果：A组患者检查中的SaO2较检查前明显下降，差异有统计学意义（P＜0.05），但B、C组患者检查前、检查中的SaO2均无明显改变。3组患者检查前、检查中的血压、心率和呼吸频率均无明显改变。A组患者的麻醉优良率与依从率均明显低于B、C组，体动呛咳率与痛苦记忆率均明显高于B、C组，差异有统计学意义（P＜0.05）；B组患者的麻醉优良率与依从率均明显低于C组，体动呛咳率与痛苦记忆率均明显高于C组，差异有统计学意义（P＜0.05）。3组患者均未见明显不良反应发生。结论：改良支气管镜雾化局麻法与改良无痛支气管镜检查法较传统支气管镜雾化局麻法麻醉效果好、安全、舒适度高，且患者易接受，改良无痛支气管镜检查法更胜一筹，但费用较贵，可根据患者具体情况选用。 |
| ABSTRACT： | OBJECTIVE： To compare anesthesia effects of 3 anesthesia methods， to investigate anesthesia improvement method for bronch fiber oscope. METHODS： 315 patients undergoing bronch fiber oscope were randomly divided into group A （106 cases）， group B （104 cases） and group C （105 cases）. Group A was treated with traditional bronch fiber oscope lidocaine atomization local anesthesia， group B was treated with modified bronch fiber oscope pethidine combined with lidocaine atomization local anesthesia and group C was treated with three-limb tube connected with laryngeal mask and target-controlled propofol and remifentanil general anesthesia. SaO2， SBP， DBP， heart rate， breathing rate， excellent anesthesia rate， compliance rate， the rate of bodymovement and choking， pain recalling rate were compared among 3 groups before and during examination， and ADR was observed. RESULTS： Compared with before examination， SaO2 of group A was decreased significantly during examination， with statistical significance （P＜0.05）； that of group B and C had no obvious change before and during examination. Blood pressure， heart rate and breathing rate of 3 groups had no obvious change before and during examination. The excellent anesthesia rate and compliance rate of group A were significantly lower than those of group B and C， but the rate of bodymovement cough and pain recalling rate were significantly higher than group B and C， with statistical significantly （P＜0.05）. The excellent anesthesia rate and compliance rate of group B were significantly lower than those of group C， but the rate of bodymovement cough and pain recalling rate were significantly higher than group C， with statistical significance （P＜0.05）. No ADR was found in 3 groups. CONCLUSIONS： Modified bronchoscope atomization local anesthesia and modified painless bronchoscope are better than traditional bronch fiber oscope atomization local anesthesia in anesthesia effect， safety， degree of comfort and acceptability. Modified bronchoscope atomization local anesthesia was best but most expensive， so these methods can be chosen according to patient’s condition. |
| 期刊： | 2016年第27卷第17期 |
| 作者： | 杨君，凌宙贵，唐贞明，蒋连强，刘卫 |
| AUTHORS： | YANG Jun，LING Zhougui，TANG Zhenming，JIANG Lianqiang，LIU Wei |
| 关键字： | 哌替啶；利多卡因；丙泊酚；瑞芬太尼；纤维支气管镜；三通连接管连接喉罩；改良；麻醉方法 |
| KEYWORDS： | Pethidine； Lidocaine； Propofol； Remifentanil； Bronchofiberscope； Three-limb tube connected with laryngeal mask； Improvement； Anesthesia method |
| 阅读数： | 304 次 |
| 本月下载数： | 3 次 |
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