CAJ | 학술논문

目的研究无痛支气管镜诊疗时利多卡因表面麻醉联合曲马多、地西泮静脉注射的麻醉效果与安全性.方法 200例患者随机分为治疗组(利多卡因表面麻醉联合静脉注射地西泮和曲马多)和对照组(单纯利多卡因表面麻醉),每组100例.表面麻醉方法为利多卡因氧气加压口鼻面罩雾化,鼻腔、气管内滴药,连续观察患者在支气管镜诊疗前、过程中血压、心率、呼吸频率、血氧饱和度变化.询问咽部不适、咳嗽、喉痉挛、疼痛、乏力、头晕、憋气、遗忘程度及对下次操作能否接受.结果治疗组患者支气管镜操作前、中的平均心率、血压无明显改变(P＞0.05),而对照组患者操作前、中平均心率明显升高(P＜0.001),组间差异存在显著性(P＜0.001).对照组患者操作中的平均血氧饱和度下降,治疗组氧饱和度无明显变化,其变化两组间差异存在显著性(P＜0.001).治疗组患者术后对操作的遗忘率高,90%表示能接受下次操作,而对照组患者对操作的不良记忆多,仅51.7%表示愿意接受下次操作,两组比较差异有显著性(P＜0.001).结论利多卡因表面麻醉加用曲马多、地西泮静脉注射用于无痛支气管镜诊疗时可以获得满意的麻醉效果,安全有效,优于常规局麻法.
목적 연구무통지기관경진료시리다잡인표면마취연합곡마다、지서반정맥주사적마취효과여안전성.방법 200례환자수궤분위치료조(리다잡인표면마취연합정맥주사지서반화곡마다)화대조조(단순리다잡인표면마취),매조100례.표면마취방법위리다잡인양기가압구비면조무화,비강、기관내적약,련속관찰환자재지기관경진료전、과정중혈압、심솔、호흡빈솔、혈양포화도변화.순문인부불괄、해수、후경련、동통、핍력、두훈、별기、유망정도급대하차조작능부접수.결과 치료조환자지기관경조작전、중적평균심솔、혈압무명현개변(P＞0.05),이대조조환자조작전、중평균심솔명현승고(P＜0.001),조간차이존재현저성(P＜0.001).대조조환자조작중적평균혈양포화도하강,치료조양포화도무명현변화,기변화량조간차이존재현저성(P＜0.001).치료조환자술후대조작적유망솔고,90%표시능접수하차조작,이대조조환자대조작적불량기억다,부51.7%표시원의접수하차조작,량조비교차이유현저성(P＜0.001).결론 리다잡인표면마취가용곡마다、지서반정맥주사용우무통지기관경진료시가이획득만의적마취효과,안전유효,우우상규국마법.
Objective To explore the effect and safety of diazepam plus tramadol intravenous combined lidocaine surface anesthesia in patients under going painless fiberoptic bronchoscopy. Methods 200 patients were separated randomly into two groups:lidocaine surface anaesthesia group (group A)and lidocaine surface anaesthesia combined diazepam plus tramadol intravenous group (group B). Patients' heart rate (HR), breathe rate, blood pressure (BP) and oxygen saturation (SpO2) before and during the operation were observed. Their cough, pain, feeble, dizziness, suffoduring the operation were counted. Then all patients were asked about the operation experience. Results Compared to the data, the mean HR and BP before and during the operation be showed significant increased in group A ( P ＜0. 001) and not in group B ( P ＞0.05). Mean SpO2 during the operation decreased significantly in group A, only 51. 7% of the patients agreed to accept the next one,and no significant difference showed in group B. There were more bad memory after the operation in group A. Nevertheless, 90% of the patients in group B were willing to accept another operation ( P ＜ 0. 001). Conclusions Lidocaine surface anaesthesia plus tramadol and diazepam in painless fiberoptic bronchoscopy is safe and effective.