两种麻醉途径对纤维支气管镜检查的临床观察

Clinical observation of the influence of two kinds of anesthesia approach on fibreoptic bronchoscopy

目的观察两种麻醉途径对纤维支气管镜检查的影响。方法将160例患者随机分为实验组和对照组各80例。两组均用2%利多卡因,分别经鼻腔和咽喉部麻醉,比较两组患者在经不同途径麻醉后,在有效麻醉时间、麻醉药物使用量、麻醉效果、出现不良反应程度及各时点(麻醉后检查前(T0)、支气管镜进入声门时(T1)检察时(T2)及检查后0.5 h(T3)的HR、MAP、Sp O2的比对。结果 1实验组患者在有效麻醉时间、麻醉药物使用量明显优于对照组(P<0.05),差异有统计学意义。2实验组麻醉效果优良率达82.5%,显著优于对照组(60%)(P<0.05),差异有统计学意义。3实验组不良反应率达19%,对照组为57.6%,差异有统计学意义。4实验组各时点各项生命体征均比B组平稳,两组在T1时点HR及MAP差异均具有统计学意义(P<0.05),且在T2时点MAP差异也具有统计学意义(P<0.05)。结论纤维支气管镜检查经鼻腔喷射麻醉优于咽喉部喷雾麻醉。

Objective To observe the influence of two kinds of anesthesia approach on fibreoptic bronchos-copy. Methods 160 patients were randomly divided into the experiment group and the control group with 80 cases in each group. The two groups were given 2% lidocaine respectively through nasal and throat. The effective time of an-esthesia, anesthetic usage, anesthesia effect and adverse reaction were compared. The value of HR, MAP and SpO2 was recorded at different time points [ after anesthesia before examination （ T0 ） , bronchoscope into glottis （ T1 ） , ex-amination （T2） and 0. 5 hours after examination （T3）]. Results （1） The effective time of anesthesia and the us-age of anesthesia drugs were better in the experiment group than in the control group （P〈0. 05）. （2） The effective rate was 82. 5% in the experiment group, which was higher than that in the control group （60%） （P〈0. 05）. （3） The incidence of adverse reaction was 19% in the experiment group and 57. 6% in the control group （P〈0. 05）. （4） The vital signs were more stable at each time point in the experiment group than in the control group, and the value of HR and MAP at T1 and the value of MAP at T2 showed significant differences between the two groups （ P〈0. 05）. Conclusion The anesthetic effect is superior through nasal to throat for fibreoptic bronchoscopy.