改良无痛纤维支气管镜技术的临床应用探讨

Investigation on the painless fibrobronchoscopy for clinical practice

目的探讨异丙酚全身麻醉加利多卡因局部麻醉下行无痛性纤维支气管镜(纤支镜)检查的临床应用价值。方法将83例纤支镜检查患者随机分为两组,异丙酚全身麻醉加利多卡因局部麻醉组(A组)42例和利多卡因局部麻醉组(B组)41例,观察记录异丙酚用量、麻醉时间和检查前中后的心率、血压、血氧饱和度变化以及术后并发症。结果 A组患者术中心率、血压、血氧饱和度与术前术后相比差异无显著性,患者耐受性好;而B组术中引起血氧饱和度下降、心率增加、血压明显上升,与术前术后比较差异有显著性(P<0.05);支气管镜通过声门和术中心率、血压、血氧饱和度变化,A组与B组比较差异有显著性(P<0.05)。结论异丙酚全身麻醉加利多卡因局部麻醉可显著提高无痛纤支镜检查患者的舒适度和安全性。

【Objective】To investigation the clinical practice of usage of propofol general anesthesia and lidocaine partial anesthesia during using fibrobronchoscopy exam. 【Methods】83 patients divided into two groups randomly （A and B group）. Group A consisted of 42 cases that was given propofol general anesthesia and lidocaine partial anesthesia,group B consisted of 41 cases that was given lidocaine partial anesthesia.During and after the procedure,observe and record the change of propofol dosage,anesthesia＇s time,heart rate,blood pressure and SaO2 and after the patient recover sense of subject assess. 【Results】After the procedure,the heart rate,blood pressure,SaO2 of group A have no much different from before,but the heart rate and the blood pressure of group B are increased,while the SaO2 is declined,which have much difference before the procedure （P〈0.05）. 【Conclusions】This technology can make the patients safer and more comfortable.