检验医学与临床
檢驗醫學與臨床
검험의학여림상
JOURNAL OF LABORATORY MEDICINE AND CLINICAL SCIENCES
2014年
z1期
85-86,87
,共3页
麻醉方式%支气管镜%活检%气胸
痳醉方式%支氣管鏡%活檢%氣胸
마취방식%지기관경%활검%기흉
anesthesia%bronchoscope%biopsy%pneumothorax
目的：通过对比单纯表面麻醉及表面麻醉联合静脉麻醉下（以下称联合麻醉）进行经支气管镜钳检活检相关气胸的发生率，以评估后者的安全性。方法选取2012年8～10月及2013年8～10月在支气管镜室行经支气管镜钳检活检的患者共452例，其中表面麻醉组198例，联合麻醉组254例，术后行胸片或胸部 CT 检查，比较两者气胸的发生率、有症状者比例、患肺受压比例、处理措施及气胸复张情况，从而评价联合麻醉下行经支气管镜钳检活检术的安全性。结果表面麻醉组198例，发生气胸为6例，占比3．03％，经吸氧等保守治疗后，100％复张；联合麻醉组254例，发生气胸8例，占比3．13％，其中6例（75％）经吸氧等保守治疗后肺复张，1例需行胸腔穿刺抽气术后复张（12．5％），另外1例需行胸腔闭式引流后复张（12．5％）。两组间气胸发生率比较差异无统计学意义（P ＞0．05）。结论联合麻醉下行经纤支镜钳检活检术并发气胸的概率与单纯表面麻醉的相当，说明联合麻醉下行经纤支镜钳检活检是安全的。
目的：通過對比單純錶麵痳醉及錶麵痳醉聯閤靜脈痳醉下（以下稱聯閤痳醉）進行經支氣管鏡鉗檢活檢相關氣胸的髮生率，以評估後者的安全性。方法選取2012年8～10月及2013年8～10月在支氣管鏡室行經支氣管鏡鉗檢活檢的患者共452例，其中錶麵痳醉組198例，聯閤痳醉組254例，術後行胸片或胸部 CT 檢查，比較兩者氣胸的髮生率、有癥狀者比例、患肺受壓比例、處理措施及氣胸複張情況，從而評價聯閤痳醉下行經支氣管鏡鉗檢活檢術的安全性。結果錶麵痳醉組198例，髮生氣胸為6例，佔比3．03％，經吸氧等保守治療後，100％複張；聯閤痳醉組254例，髮生氣胸8例，佔比3．13％，其中6例（75％）經吸氧等保守治療後肺複張，1例需行胸腔穿刺抽氣術後複張（12．5％），另外1例需行胸腔閉式引流後複張（12．5％）。兩組間氣胸髮生率比較差異無統計學意義（P ＞0．05）。結論聯閤痳醉下行經纖支鏡鉗檢活檢術併髮氣胸的概率與單純錶麵痳醉的相噹，說明聯閤痳醉下行經纖支鏡鉗檢活檢是安全的。
목적：통과대비단순표면마취급표면마취연합정맥마취하（이하칭연합마취）진행경지기관경겸검활검상관기흉적발생솔，이평고후자적안전성。방법선취2012년8～10월급2013년8～10월재지기관경실행경지기관경겸검활검적환자공452례，기중표면마취조198례，연합마취조254례，술후행흉편혹흉부 CT 검사，비교량자기흉적발생솔、유증상자비례、환폐수압비례、처리조시급기흉복장정황，종이평개연합마취하행경지기관경겸검활검술적안전성。결과표면마취조198례，발생기흉위6례，점비3．03％，경흡양등보수치료후，100％복장；연합마취조254례，발생기흉8례，점비3．13％，기중6례（75％）경흡양등보수치료후폐복장，1례수행흉강천자추기술후복장（12．5％），령외1례수행흉강폐식인류후복장（12．5％）。량조간기흉발생솔비교차이무통계학의의（P ＞0．05）。결론연합마취하행경섬지경겸검활검술병발기흉적개솔여단순표면마취적상당，설명연합마취하행경섬지경겸검활검시안전적。
Objective Compared the incidence of pneumothorax intrans bronchial forceps biopsy of the pure surface anesthesia and that of the surface anesthesia combined with intravenous anesthesia(hereinafter called the com-bined anesthesia)to assess the safety of the latter.Methods There were a total of 452 cases did trans bronchial for-ceps biopsy from August to October in 2012 and in 2013,including 198 cases with surface anesthesia 254 cases with surface anesthesia combined anesthesia,postoperative chest X-ray and chest CT examination were took after opera-tion,the incidence of symptomatic patients,proportion,lung compression ratio,treatment measures and pneumothorax recruitment situation were compared to evaluate the safety of the bronchoscopy forceps biopsy through the the sur-face anesthesia combined anesthesia.Results Among 198 cases with surface anesthesia,6 cases appeared pneumotho-rax with the ratio as 3.03%,gave the oxygen and other conservative treatment,100% lung recruited;254 cases in combined anesthesia group,8 cases appeared pneumothorax accounted for more than 3.13%,in which 6 cases(75%) lung recruited after giving oxygen inhalation and other conservative treatment,1 patients needed thoracic puncture as-piration for reexpansion(12.5%),another 1 cases of closed thoracic drainage required reexpansion(12.5%).There were no statistically significant differences between the two groups(P >0.05).Conclusion The incidence of pneumo-thorax intrans bronchial forceps biopsy of the pure surface anesthesia combined with intravenous anesthesia meets that of the simple surface anesthesia,it shows that the combined anesthesia via fiberoptic bronchoscopy forceps biop-sy is safe.
