CAJ | 학술논문

目的研究支气管镜诊疗时右旋美托咪啶联合芬太尼静脉注射的麻醉效果与安全性.方法两组患者各100例,治疗组:利多卡因表面麻醉联合静脉注射右旋美托咪啶和芬太尼,对照组:单纯利多卡因表面麻醉.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.连续观察两组患者在支气管镜诊疗前、诊疗中血压、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、血压明显升高(P＜0.05),其变化两组间差异有统计学意义(P＜0.05);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,其变化两组间差异有统计学意义(P＜0.05);治疗组患者术后对操作的遗忘率高,90.0％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41.0％表示愿意接受下次操作,两组比较差异有统计学意义(P＜0.05).结论利多卡因表面麻醉加用右旋美托咪啶联合芬太尼静脉注射用于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 연구지기관경진료시우선미탁미정연합분태니정맥주사적마취효과여안전성.방법 량조환자각100례,치료조:리다잡인표면마취연합정맥주사우선미탁미정화분태니,대조조:단순리다잡인표면마취.표면마취방법위리다잡인양기가압구비면조무화,비강、기관내적약.련속관찰량조환자재지기관경진료전、진료중혈압、심솔、호흡빈솔、혈양포화도변화.순문인부불괄、해수、후경련、동통、핍력、두훈、별기、유망정도급대하차조작능부접수.결과 치료조환자지기관경조작전、중적평균심솔、혈압무명현개변(P＞0.05),이대조조환자조작전、중평균심솔、혈압명현승고(P＜0.05),기변화량조간차이유통계학의의(P＜0.05);대조조환자조작중적평균혈양포화도하강,치료조양포화도무명현변화,기변화량조간차이유통계학의의(P＜0.05);치료조환자술후대조작적유망솔고,90.0％표시능접수하차조작,이대조조환자대조작적불량기억다,부41.0％표시원의접수하차조작,량조비교차이유통계학의의(P＜0.05).결론 리다잡인표면마취가용우선미탁미정연합분태니정맥주사용우지기관경진료시가이획득만의적마취효과,안전、유효,우우상규국마법.
Objective To explore the effect and safety of dexmedetomidine and fentanyl intravenous injection combined with lidocaine surface anesthesia in patients under going fiberoptic bronchoscopy.Methods 200 patients were separated randomly into two groups:treatment group received lidocaine surface anaesthesia combined with dexmedetomidine and fentanyl intravenous injection,control group received lidocaine surface anaesthesia.The heart rate,breathe rate,blood pressure and oxygen saturation before and during the operation were continually observed.Their cough,pain,feeble,dizziness during the operation were counted.Then all patients were asked about the operation experience.Results Compared to the data before fiberoptic bronchoscopy,the heart rate and blood pressure before and during the operation significantly increased in control group (P ＜0.05),but not changed significantly in treatment group.The oxygen saturation during the operation significantly decreased in control group (P ＜0.05),and showed no significant change in treatment group.There were more bad memory after the operation in control group compared with treatment group.Nevertheless,90.0％ patients in treatment group were willing to accept another operation,41.0％ patients in control group were willing to accept another operation,and there was significant difference between the two groups (P ＜0.05).Conclusions Using lidocaine surface anaesthesia with dexmedetomidine and fentanyl in fiberoptic bronchoscopy in patients is safe and effective.