神经阻滞配合全麻下行硬质气管镜治疗患者的插管反应探讨

Study of Intubation Response of Patients Treated with Rigid Bronchoscopy Under Nerve Block Combined with General Anesthesia

目的探讨在神经阻滞配合全麻下行硬质气管镜治疗,对患者插管反应的临床应用效果和影响情况。方法随机抽取中山大学附属第八医院2018年5月至2019年5月在外科进行硬质气管镜介入术治疗的60例患者为研究对象。采用随机数字表法分为麻醉组(B组)和对照组(N组),各30例:B组患者采用超声引导下喉上神经阻滞联合气管内表面麻醉,N组患者采用常规麻醉。比较2组患者在不同时间点的平均动脉压(MAP)、心率(HR)和血糖指标水平变化情况。结果2组患者在T0、T1时间点上的MAP、HR和血糖指标水平比较,差异无统计学意义(P>0.05)。在T2、T3、T4、T5时间点上,B组患者的MAP、HR指标水平、血糖水平低于对照组患者,差异有统计学意义(P<0.05)。结论硬质气管镜治疗患者实施神经阻滞配合全麻进行手术,其临床效果显著,能够有效减轻患者插管的应激反应,维持手术期间血流动力学的相对稳定,具有较高的临床应用价值。

Objective To study the clinical effect and influence intubation response of patients of rigid tracheoscopy under nerve block combined with general anesthesia.Methods A total of 60 patients with rigid bronchoscopy intervention admitted into the Eighth Affiliated Hospital of Sun Yat-sen University From May 2018 to May 2019 were selected as object of study and randomLy divided into anesthesia group(Group B)and control group(Group N),with 30 cases in each group.Group B was treated with superior laryngeal nerve block under the guidance of ultrasound combined with intratracheal surface anesthesia,and group N was treated with routine anesthesia.The changes of map,HR and blood glucose at different time points in the two groups were compared.Results According to clinical statistics,there was no significant difference in map,HR and blood glucose between the two groups at T0 and T1 time points(P>0.05).At T2,T3,T4 and T5 time points,the levels of map,HR and blood glucose in group B were lower than those of the control group,with statistically significant differences(P<0.05).Conclusion Rigid bronchoscopy under nerve block combined with general anesthesia can effectively reduce the stress response of patients during intubation,maintain the relative stability of hemodynamics during the operation,and has high clinical application value.