阿托品在支气管镜检查中的作用探讨

Discussion of Application of Atropine in Bronchoscopy

目的:探讨阿托品在支气管镜检查中的作用,促进临床合理用药。方法:将100例患者根据术前准备方法不同随机均分为2组。A组:给予2%利多卡因雾化吸入表面麻醉,并于术前30min肌肉注射阿托品1mg;B组:给予2%利多卡因雾化吸入表面麻醉。分别记录术前(T1)、通过咽部(T2)、通过声门(T3)、气管内注入2%利多卡因后(T4)、操作过程中(T5)、结束时(T6)的心率(HR)、血氧饱和度(SPO2),并记录T1和T6的血压(BP)等数据。结果:2组术后HR均从T3开始增快,与术前比较,差异具有统计学意义(P<0.05);A组各时间点SPO2比较,差异无统计学意义(P>0.05);B组从T3开始下降,差异有统计学意义(P<0.05)。A组收缩压(SBP)组内比较无统计学意义(P>0.05);B组SBP升高,并具有统计学意义(P<0.05)。A组HR在T1、T2、T3、T6时均高于B组,差异具有统计学意义(P<0.05),但在T4、T5时2组间比较,差异无统计学意义(P>0.05)。结论:虽然阿托品有增快患者HR的副作用,但在支气管镜检查过程中能使患者保持更稳定的HR、SPO2及SBP,对患者有保护作用,可在支气管镜检查的术前常规应用。

OBJECTIVE：To discuss the value of atropine in bronchoscopy.METHODS：100 patients were randomly divided into 2 groups according to different preoperative preparation.Group A was given aerosol inhalation of 2% lidocaine to anesthesia and given atropine 1 mg,30 min before operation;group B was given inhalational anesthesia only.The heart rate（HR） and oxygen saturation of blood（SPO2） were recorded before bronchoscopy（T1）,crossing the laryngeal art of parynx（T2） and the glottis（T3）,injecting with 2% lidocaine in the trachea（T4）,during the bronchoscopy（T5） and after bronchoscopy（T6）.The blood press（BP） before and after bronchoscopy were observed.RESULTS：HR of 2 groups increased significantly from T3,there was significant difference（P0.05）.SPO2 of group had no statistical difference at different time points;they decreased from T3 in group B,there was statistical difference（P0.05）.The systole blood pressure（SBP） of group A had no statistical difference（P0.05）;that of group B was increasing,there was statistical difference（P0.05）.HR of group A was higher than those of group B at T1,T2,T3,T6,there was statistical difference（P0.05）.There was no statistical difference in HR between 2 groups at T4,T5（P0.05）.CONCLUSION：The HR,SPO2 and SBP of patients who are given atropine before bronchoscopy are more stable during the examination although atropine will increase HR.It plays protective effect on patients and should be included in conventional preoperative therapy of bronchoscopy.