无痛支气管镜检查技术在临床中的应用

Painless Bronchoscopy Technology in Clinical Application

目的探讨无痛支气管镜检查技术在临床操作中的可行性及应用价值。方法回顾性分析2012年1月-2012年12月我科支气管镜检查患者的临床资料90例，根据受检者的意愿分为无痛治疗组（36例）和常规治疗组（54例）。无痛治疗组在常规治疗组基础上应用芬太尼、咪达唑仑镇痛、镇静处理，观察两组患者检查前、检查中及检查后的血氧饱和度、血压、脉搏和呼吸变化及耐受性。结果无痛治疗组36例受检患者血压轻度下降、心率轻度增快、氧饱和度无明显下降，顺利完成相应检查及治疗，无明显不适应感，无痛苦及精神创伤，完全清醒后平均20min离开检查室。常规治疗组54例受检患者均出现不同程度呛咳、憋气及体动等不良反应，检查后均感痛苦及精神创伤。结论局部麻醉＋（芬太尼、咪达唑仑）镇痛镇静下行支气管镜检查能明显减轻患者的痛苦，患者舒适度提高，无明显不良反应，且安全、操作简便。可以在临床工作中推广运用。

Objective To study the painless bronchoscopy technology in clinical operation of the feasibility and applica- tion value. Methods A retrospective analysis from January 2012 to 2012 December I branch bronchoseopy the clinical data of 90 cases of patients, according to the wishes of the client~ divided into two groups, painless treatment group （36 cases） and the con- ventional treatment group （54 cases）, painless treatment group in the conventional treatment group on the basis of application of fentanyl, midazolam analgesia, calm processing, observe two groups of patients before inspection, cheek and inspection of the blood oxygen saturation, blood pressure, pulse and breathing change and tolerance. Results 36 cases painless treatment group client blood pressure in patients with mild decline, the heart rate mild increase fast, oxygen saturation no declined obviously, and successfully completed the corresponding inspection and treatment, no obvious dont adapt to the feeling, no pain and mental trau- ma, fully awake on average after twenty minutes away from inspection chamber. Conventional treatment group of 54 patients with client all appear different degree choke cough, labored breathing and body moving and other adverse reaction, after check all feel pain and mental trauma. Conclusion Local anesthesia ＋ （fentanyl, midazolam） analgesic calm down bronchoseopy can signifi- cantly reduce the pain of patients, improve patient comfort, no obvious adverse reaction, and safety, easy operation, can promote the use in the clinical work.