局部麻醉伴或不伴清醒镇静行超声支气管镜检查的对照研究

Comparison of Local Anesthesia with Conscious Sedation and Simple Local Anesthesia in Endobronchial Ultrasound

目的:比较局部麻醉伴或不伴清醒镇静方式用于支气管内超声引导下经支气管针吸活检(EBUS-TBNA)时患者的满意度、耐受度及安全性等,以筛选更合适的麻醉方法。方法:将行EBUS-TBNA检查的60例患者随机分为局部麻醉伴清醒镇静组(A组)和单纯局部麻醉组(B组),每组30例。通过术前记录、术中观察、术后问卷和随访的方式观察患者对操作的满意度和耐受度、操作的安全性和诊断的准确性。结果:与B组比较,A组EBUS-TBNA术前、术中、术后血氧饱和度明显降低(P<0.05);收缩压在EBUS-TBNA术前和术中略有降低(P<0.05);两组患者的满意度和耐受度、并发症的发生率、诊断准确率差异无统计学意义。结论:对在门诊行EBUS-TBNA的患者可采用单纯局部麻醉的方式,患者的满意度和耐受度、操作的安全性、诊断的准确性较高。

Objective：To compare the satisfaction and tolerability of patients under local anesthesia with conscious sedation and simple local anesthesia in Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration （EBUS-TBNA） .Methods ：Sixty patients undergoing EBUS-TBNA operation were randomly divided into local anesthesia with conscious sedation group （Group A） and simple local anesthesia group （Group B） ,with 30 patients in each group .The satisfaction and tolerability of patients , safety and accuracy of operations were observed by preoperative records ,intraoperative observation ,postoperative question-naires and follow-up .Results ：Compared with Group B ,the blood oxygen saturations of patients before ,during and after oper-ation in Group A decreased significantly （P〈0 .05） .The mean contractive pressure of patients before and during operation in Group A were significantly lower than that in Group B .However ,there were no significant differences in the satisfaction and tolerability ,the incidence rates of complications of patients and diagnostic accuracy in two groups .Conclusions ：The simple lo-cal anesthesia in EBUS-TBNA in Outpatient Department is safe and effective ,with good satisfaction and tolerability .