气管插管机械通气在无痛纤维支气管镜检查中的应用效果

Tracheal intubation and mechanical ventilation in painless fiberoptic bronchoscopy

目的 评价气管插管机械通气下无痛支气管镜检查的安全性和舒适性.方法 将拟行无痛支气管镜检查的46例患者随机分为对照组（全麻无气管插管组,23例）和试验组（全麻有气管插管机械通气组,23例）.观察记录两组患者术前及术中生命体征（RR、HR、BP、SPO2）的变化、不良反应及术后满意度.结果 对照组2例出现呼吸抑制、氧饱和度下降而改为插管机械通气继续检查,试验组无中断检查病例.两组生命体征RR、HR、BP差异无统计学意义;对照组SPO2高于试验组（P＜0.05）;试验组术中不良反应发生率明显低于对照组（P＜0.05）;试验组苏醒时间长于对照组（P＜0.05）;两组患者术后舒适度及满意率差异无统计学意义（P＞0.05）.结论 气管插管机械通气下纤支镜检查相比一般无痛纤支镜检查不增加患者痛苦,虽然术后苏醒时间延长,但更安全可靠,值得临床推广.

Objective To evaluate the safety and comfort of tracheal intubation and mechanical ventilation in painless bronchoscopy.Methods 46 patients undergoing painless bronchoscopy were randomly divided into a control group （a group by general anesthesia without tracheal intubation,23 cases） and an experimental group （a group by tracheal intubation and mechanical ventilation with general anesthesia,23 cases）.The changes in the preoperative and intraoperative vital signs （R,HR,SPO2,BP）,adverse reactions,postoperative satisfaction degree of the two groups were observed and recorded.Results In the control group,2 cases changed over to intubation and mechanical ventilation for completion of the checking due to respiratory depression and oxygen desaturation;while no check interruption occurred in the experimental group.There was no statistical differences in the vital signs of R,HR and BP between these two groups.The SPO2 of the experimental group was lower than that of the control group （P ＜ 0.05）.The incidence of adverse reactions of the experimental group was significantly lower than that of the control group （P ＜ 0.05）.The time to consciousness of the experimental group was longer than that of the control group （P ＜ 0.05）.There was no statistical differences in in the postoperative comfort and satisfaction degree between these two groups （P ＜ 0.05）.Conclusions In comparison with general painless fiberoptic bronchoscopy,fiberoptic bronchoscopy with tracheal intubation and mechanical ventilation does not make the patients suffer more,although there is prolongation of postoperative recovery.But it is more safe and reliable,therefore,it is worth being clinically generalized.