CAJ | 학술논문

目的：：评价咪达唑仑-芬太尼复合麻醉在电子支气管镜检查中的镇静作用及安全性。方法：行电子支气管镜检查患者104例,随机分为咪达唑仑-芬太尼组( A组)和常规对照组( B组)各52例。所有患者检查前常规以2％利多卡因喷鼻腔、咽喉部4次,表面局部麻醉,1.5 ml/min静脉输注0.9％氯化钠注射液。 A组检查前5 min缓慢静脉输注咪达唑仑3.0 mg+芬太尼50μg；B组输注0.9％氯化钠注射液5 ml。2组患者均在用药后2 min进行电子支气管镜检查。记录2组患者用药前( T0)、用药后2 min( T1)、用药后5 min( T2)、用药后10 min( T3)、用药后15 min( T4)及用药后30 min( T5)的收缩压( SBP)、平均动脉压( MAP)、呼吸( RR)、心率( HR)和血氧饱和度( SpO2)及患者呛咳、恶心呕吐、憋气、中断检查及不良记忆等不适反应。结果：A组T1~T3 SBP、T1~T4 MAP和HR均较T0降低(P<0.05~P<0.01),而T5 SBP、T1~T4 MAP和HR及T1~T5 RR与T0差异均无统计学意义(P>0.05)。 B组患者T1~T4 MAP和HR均较T0和A组增高(P<0.05~P<0.01),2组SpO2均较T0下降(P<0.01),但B组T1~T4 SpO2均低于A组(P<0.01)。 B组患者呛咳、恶心呕吐、憋气和不良记忆等不良反应的发生率均较A组高(P<0.05~P<0.01),B组8例因刺激过大而中断检查。结论：咪达唑仑-芬太尼复合麻醉是电子支气管镜检查中患者良好镇静的理想临床用药。
목적：：평개미체서륜-분태니복합마취재전자지기관경검사중적진정작용급안전성。방법：행전자지기관경검사환자104례,수궤분위미체서륜-분태니조( A조)화상규대조조( B조)각52례。소유환자검사전상규이2％리다잡인분비강、인후부4차,표면국부마취,1.5 ml/min정맥수주0.9％록화납주사액。 A조검사전5 min완만정맥수주미체서륜3.0 mg+분태니50μg；B조수주0.9％록화납주사액5 ml。2조환자균재용약후2 min진행전자지기관경검사。기록2조환자용약전( T0)、용약후2 min( T1)、용약후5 min( T2)、용약후10 min( T3)、용약후15 min( T4)급용약후30 min( T5)적수축압( SBP)、평균동맥압( MAP)、호흡( RR)、심솔( HR)화혈양포화도( SpO2)급환자창해、악심구토、별기、중단검사급불량기억등불괄반응。결과：A조T1~T3 SBP、T1~T4 MAP화HR균교T0강저(P<0.05~P<0.01),이T5 SBP、T1~T4 MAP화HR급T1~T5 RR여T0차이균무통계학의의(P>0.05)。 B조환자T1~T4 MAP화HR균교T0화A조증고(P<0.05~P<0.01),2조SpO2균교T0하강(P<0.01),단B조T1~T4 SpO2균저우A조(P<0.01)。 B조환자창해、악심구토、별기화불량기억등불량반응적발생솔균교A조고(P<0.05~P<0.01),B조8례인자격과대이중단검사。결론：미체서륜-분태니복합마취시전자지기관경검사중환자량호진정적이상림상용약。
Objective:To evaluate the sedative effects and safety of the compound anesthesia of midazolam-fentanyl during the detection of electronic bronchoscopy. Methods:One hundred and four patients detected by the electronic bronchoscopy were randomly divided into the midazolam-fentanyl group ( A group ) and conventional group ( B group ) ( 52 cases each group ) . The 2% lidocaine spraying nasal and throat surface for 4 times,and 0. 9% saline infusion(dripping speed of 1. 5 ml/min) were used in all patients before check. Before 5 min of check,the 3. 0 mg midazolam combined with 50μg fentanyl and 5 ml 0. 9% saline infusion were slowly injected into A group and B group,respectively. Two groups were detected after 2 min of using drug. The systolic blood pressure(SBP),mean arterial pressure( MAP) ,breathing( RR) ,heart rate( HR) and blood oxygen saturation( SpO2 ) before using drug( T0 ) and after 2 min (T1),5 min(T2),10 min(T3),15 min(T4) and 30 min(T5) of medication in two groups were recorded,and the cough,nausea, vomiting,breath control,interrupt checking and bad memories in two groups were observed. Results:Among A group,the SBP at T1 to T3,and MAP & HR at T1 to T4 were lower than those at T0(P<0. 05 to P<0. 01),and the differences between the SBP at T5,MAP and HR at T1 to T4 and RR at T1 to T5 and those at T0 were not statistical significance(P>0. 05). The MAP and HR at T1 to T4 in B group were higher than those at T0 in B group and A group(P <0. 05 to P <0. 01). Compared with T0,the SpO2 in two groups decreased(P<0. 01),but the SpO2 at T1 to T4 in B group were lower than those in A group(P<0. 01). The incidence rates of choke, cough,nausea,vomiting,bad breath and memory in B group were higher than those in A group(P<0. 05 to P<0. 01),The check in 8 cases of B group were interrupted by the excessive stimulus. Conclusions:The compound anesthesia of midazolam-fentanyl is an ideal clinical sedation drug in patients detected by the electronic bronchoscopy.