镇静镇痛在支气管内膜结核患者气道介入治疗中的应用研究

Study on application of sedation and analgesia in airway interventional treatment of patients with endobronchial tuberculosis

目的探讨不同镇静镇痛方式在支气管内膜结核患者多次气道介入治疗中的应用效果。方法将2016年5月至2018年11月该院收治的91例接受气道介入治疗的支气管内膜结核患者采用随机数字表法分为对照组(45例)和研究组(46例)。对照组采取传统静脉滴注哌替啶镇痛的方式,研究组采用静脉持续泵入咪达唑仑联合芬太尼镇静镇痛的方式。利用焦虑自评量表(SAS)评估2组患者术前焦虑感。前3次手术时每次均进行评估,在患者接受第4~7次治疗时进行第4次评估。结果2组患者接受介入手术总次数、首次及第2次气道介入术前SAS评分比较,差异均无统计学意义(P>0.05);第3、4~7次气道介入术前SAS评分比较,差异均有统计学意义(P<0.05);2组患者均未发生严重药物不良反应。结论对于需多次接受气道介入治疗的支气管内膜结核患者在术时采用咪达唑仑联合芬太尼镇静镇痛的方式可减轻患者术中的痛苦感与恐惧感及再次手术前的焦虑感,提高患者对治疗的依从性。

Objective To investigate the application effect of different sedation and analgesia modes in the multiple airway interventional therapy for the patients with endobronchial tuberculosis.Methods A total of 91 patients with endobronchial tuberculosis receiving the airway interventional therapy in the hospital from May 2016 to November 2018 were divided into the control group(n=45)and study group(n=46)by adopting the random number table method.The control group adopted the traditional dolantin intravenous drip analgesia,while the study group adopted the sedation and analgesia mode of persistent intravenous pumping of midazolam combined with fentanyl.The self-rating anxiety scale(SAS)was used for conducting the preoperative evaluation.The each time of the first three operations was evaluated,the fourth evaluation was performed at the time receiving 4-7 times of treatment.Results There was no statistically significant difference in the total number of interventional operations and the SAS scores at the first time and the second time of airway interventional therapy between the two groups;there was statistically significant difference in the SAS score before 3,4-7 times of airway interventional operation(P<0.05).No serious drug adverse reactions occurred in the two groups.Conclusion Adopting the midazolam combined with fentanyl sedation and analgesia mode can reduce the intraoperative pain feeling and fear feeling,and anxiety feeling of re-operation in the patients with endobronchial tuberculosis receiving the airway interventional therapy,and increase the therapeutic compliance of the patients.