利多卡因联合咪达唑仑行纤维支气管镜检查的临床观察

Lidocaine combined midazolam line fiber bronchoscopy clinical observation

目的:研究利多卡因联合咪达唑仑行纤维支气管镜检查对呼吸、循环及不良反应记忆的影响。方法:将我院2013年1月~2017年6月呼吸科及重症医学科收治的60例需行纤维支气管镜检查的患者分为两组。对照组为30例A组;观察组30例为B组。A组为单用利多卡因局部表面麻醉。B组为在采用利多卡因局部表面麻醉后联合咪达唑仑静脉泵注。采用多功能监护仪监测对比两组术前、术中、术后的心率、平均动脉压、呼吸次数、末梢血氧饱和度变化及术后对术中过程的记忆。结果:B组麻醉后能在较舒适的状态下接受检查,两组在术中心率、平均动脉压、呼吸次数、末梢血氧饱和度变化上的差异有统计学意义(P<0.05),术后心率、平均动脉压、呼吸次数的差异有统计学意义(P<0.05),末梢血氧饱和度变化的差异无统计学意义(P>0.05)。B组不良反应发生率及术后不良反应发生率也明显低于A组。结论:采用利多卡因联合咪达唑仑行纤维支气管镜检查,麻醉效果好,是一种相对安全的方法,可以减少对纤维支气管镜检查不良反应的记忆。

Objective： To study the effect of ]idocaine combined with midazolam on bronchoscopy in patients with respiratory, circulatory and adverse events. Methods： A total of 60 patients who underwent fiberoptic bronehoscopy were divided into two groups： the Department of Respiratory Medicine and the Department of Emergency Medicine, January 2013 - June 2017. The control group was 30 cases of group A; midazolam group of 30 eases of group 13. Group A was treated with lidoeaine alone for topical anesthesia. Group B in the use of lidocaine local surface anesthesia combined with midazolam intravenous injection. The heart rate, mean arterial pressure, respiratory rate, peripheral blood oxygen saturation （MAP） and postoperative heart rate （mean arterial pressure） were measured by multifunctional monitor. The memory of intraoperative procedure was compared between the two groups. Results： In group B, the patients were able to be tested in a more comfortable state. The difference of intracardiogram heart rate, mean arterial pressure, respiratory rate and peripheral blood oxygen saturation was statistically significant （P〈0.05） The difference of postoperative heart rate, mean arterial pressure and respiratory rate was statistically significant （P〈0.05）, and there was no significant difference in peripheral blood oxygen saturation （P〉O.05）. The incidence of adverse reactions and the incidence of adverse reactions were significantly lower in group B than in group A. Conclusion： The use of lidocaine combined with midazolam fiberoptic bronchoscopy, anesthesia effect is a relatively safe method, can reduce the patients on the fiber bronchoscopy adverse reactions memory.