可视化术前宣教联合改良利多卡因含漱法局部麻醉在支气管镜检查中的应用

Application effect of visual preoperative education combined with improved lidocaine gargle for local anesthesia in bronchoscopy

目的探讨可视化术前宣教联合改良利多卡因含漱法局部麻醉在支气管镜检查中的应用效果。方法选取2019年5月至2021年4月上海市青浦区朱家角人民医院内科收治的100例支气管镜检查患者作为研究对象,按照随机数表法分为A、B两组,每组50例。A组患者采用常规护理宣教,并进行传统利多卡因喷雾联合利多卡因含漱法。B组患者采用可视化术前宣教,并给予改良式利多卡因含漱局部麻醉。比较两组患者电子支气管镜检查的麻醉效果,进支气管镜前(T1)、支气管镜抵达声门(T2)、支气管镜到达隆突(T3)及支气管镜退出声门(T4)4个时间点患者的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO_(2))数值;同时比较两组患者住院期间的不良反应发生情况。结果B组患者的麻醉优良率为100.0%,明显优于A组的80.0%,差异具有统计学意义(P<0.05);与A组比较,B组患者在T3、T4时点的MAP和HR更平稳,差异均有统计学意义(P<0.05);A组患者麻醉后在T3、T4时点的SpO_(2)分别为(94.0±4.2)%和(88.9±5.1)%,明显低于B组的(97.9±5.4)%和(97.5±5.6)%,差异均有统计学意义(P<0.05);治疗期间B组患者的总不良反应发生率为2.0%,明显低于A组的10.0%,差异有统计学意义(P<0.05)。结论可视化术前宣教联合改良利多卡因含漱法局部麻醉在支气管镜检查中的应用能够改善受检者的MAP、HR、SpO_(2)指标,有利于支气管镜检查的顺利进行,临床应用效果显著,值得推广应用。

Objective To explore the effect of visual preoperative education combined with improved lidocaine gargle for local anesthesia in bronchoscopy.Methods A total of 100 patients undergoing bronchoscopy,who admitted to Department of Internal Medicine at Zhujiajiao People’s Hospital of Qingpu District of Shanghai from May 2019 to April 2021,were selected and divided into two groups,A and B,according to random number table method,with 50 patients in each group.Group A received routine nursing education and lidocaine spray combined with lidocaine gargle,and group B received visual preoperative education and local anesthesia with modified lidocaine gargle.The anesthesia effect of electronic bronchoscopy was compared between the two groups.The anesthesia effects of the electronic bronchoscopy for both groups at the four time points[before bronchoscopy(T1),bronchoscope reaches the glottis(T2),bronchoscope reaches the carina(T3),and bronchoscope exits the glottis(T4)]were compared.The mean arterial pressure(MAP),heart rate(HR),peripheral oxygen saturation(SpO_(2))values,and the time required for the bronchoscope to pass the glottis were also compared at 4 time points.The adverse reactions during hospitalization,including wound pain,nausea,vomiting,dizziness,were observed and recorded.Results The good rate of anesthesia in group B was 100.0% versus 80.0% in group A(P<0.05).Compared with group A,MAP and HR of group B were more stable at T3 and T4,and the differences were statistically significant(P<0.05).SpO_(2)of group A were(94.0±4.2)% and(88.9±5.1)% at T3 and T4,respectively,which were significantly lower than corresponding(97.9±5.4)% and(97.5±5.6)% of group B(P<0.05).During the treatment,the incidence of total adverse reactions in group B was 2.0%,which was significantly lower than10.0% in group A(P<0.05).Conclusion Visual preoperative education combined with modified lidocaine gargle for local anesthesia in bronchoscopy can improve the MAP,HR,and SpO_(2)indicators of the subject,which is conducive to the smooth progress of the bronchoscopy.It has significant clinical application effect and is worthy of promotion application.