瑞芬太尼复合丙泊酚靶控输注在老年肺部疾病患者纤维支气管镜检查中的应用

Clinical application of target-controlled infusion with propofol and remifentanil for elderly patients with pulmonary disease in fiberbronchoscopy

目的:观察瑞芬太尼复合丙泊酚靶控输注在老年肺部疾病患者无痛纤维支气管镜检查中的安全性及可行性。方法:40例老年患者随机分为两组,芬太尼组(Ⅰ组)手控推注丙泊酚与芬太尼,瑞芬太尼组(Ⅱ组)靶控输注丙泊酚与瑞芬太尼。观察并记录各组各时点的收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、心率(heart rate,HR)、患者诱导时间、镜检时间、苏醒时间及检查过程中患者的不良反应。结果:与Ⅰ组相比,Ⅱ组诱导时间及苏醒时间明显缩短(P<0.05);镜检过程中血流动力学稳定(P<0.05)。结论:靶控输注丙泊酚、瑞芬太尼,辅用自制改良面罩,可安全应用于老年肺部疾病患者的无痛纤支镜检查。

Objective： To observe the feasibility and safety of blood target-controlled infusion with propofol and remifentanil for elderly patients with pulmonary disease in fiberbronchoscopy.Methods： 40 elderly patients were randomly divided into a fentanyl group（Group Ⅰ） and a remifentanil group（Group Ⅱ）.GroupⅠpropofol and fentanyl were infused by intravenous,manually and respectively.Group Ⅱ propofol and remifentanil were given by target controlled infusion（TCI）,respectively.At each time point,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,and heart rate（HR）,induction time,operating time,awaking time and adverse reactions of each group during the patients inspection were recorded.Results： Compared with group Ⅰ,the induction time and the awaking time in group Ⅱ were significantly lower.The hemodynamic fluctuation was more stable in group Ⅱ（P0.05）.Conclusion： Prepofol combining remifentanil by TCI,using self-made modified facial mask is safe and effective for elderly patients with pulmonary disease in fiberbronchoscopy.