高频通气加靶控输注在无痛纤支镜中的应用

Application of High Frequency Ventilation and Target Controlled Infusion Anesthesia in Painless Diagnosis and Treatment Tuberculosis by Fiberobronchoscopy

目的探讨高频通气加靶控输注在无痛纤支镜诊治疗中的应用。方法以高频通气加靶控输注全麻下,行纤支镜诊治肺结核62例,分别进行吸除痰液、支气管肺泡灌洗等综合治疗。分别记录T0、T1、T2、T3、T4及T5时的Bp、HR和SpO2,计算RPP,观察镜检期间有无呛咳及体动,在苏醒后询问有无术中知晓。结果T1时的Bp、RPP低于T0时(P<0.05),HR比较差异无显著性;T2～T5时的Bp、RPP和HR不高于T0;纤支镜检查期间所有患者的SpO2维持在麻醉前值或以上,无一例出现呛咳、体动及术中知晓。结论高频通气加靶控输注具有安全、舒适、血流动力学稳定、副作用少的特点,是无痛纤支镜诊治的一种理想的麻醉方法。

Objective To evaluate the efficiency of high frequency ventilation and target controlled infusion（TCI） anesthesia in painless diagnosis and treatment of tuberculosis with fiberobronchoscopy. Methods 62 cases of tuberculosis were treated by fiberobronchoscopy with high frequency ventilation and TCI anesthesia. The Bp, HR and SpO2 were measured at the following time points：T0,T1,T2,T3,T4 and T5. Laryngospasm and cough were observed, and the RPP at every time point was also calculated. Results Compared to TO, a significant decrease in Bp and RPP（ P 〈 0.05 ） ,while no significant change in HR was observed at T1. The Bp, RPP and HR at T2-T5 didn＇t exceed their baseline values at T0. During FOB the SpO2 was kept at or above baseline values,no cough,body movement and awareness were observed. Conclusion High frequency ventilation and TCL anesthesia is comfortable and safe in the treatment of tuberculosis by bronchoscopy, and the patients hemodynam and respiratory activity were stable.