瑞马唑仑联合舒芬太尼对做纤维支气管镜检查患者镇静成功率、应激反应以及肺功能的影响

Effects of remazolam combined with sufentanil on sedation success,stress response and pulmonary function in patients undergoing fiberoptic bronchoscopy

目的 探讨瑞马唑仑联合舒芬太尼对做纤维支气管镜检查患者镇静成功率、应激反应以及肺功能的影响。方法 选取2022年1—12月海南省肿瘤医院/海南医学院附属肿瘤医院收治的129例拟做纤维支气管镜检查的患者为研究对象,采用随机数字表法分为A组、B组和C组,每组43例。A组患者给予瑞马唑仑联合舒芬太尼,B组患者给予瑞马唑仑联合芬太尼,C组患者给予瑞马唑仑联合瑞芬太尼。比较分析三组患者进镜前(T_(1))、镜至声门时(T_(2))、镜至隆突时(T_(3))、检查结束时(T_(4))的血流动力学水平和镇静程度,检查前后的应激反应指标和肺功能,苏醒时间、检查时间、镇静成功率以及检查期间和检查结束后的不良反应发生情况。结果 T_(1)、T_(2)、T_(3)、T_(4)时刻,三组患者的心率、平均动脉压、脑电双频指数比较差异均无显著性(P>0.05)。T_(2)、T_(3)时刻,A组患者的警觉/镇静观察评分显著低于B组和C组(P<0.05)。检查结束时,A组患者的血清血管紧张素Ⅱ、醛固酮水平均显著低于B组和C组(P<0.05),且B组显著低于C组(P<0.05)。检查前、苏醒后10min、检查结束后6h,三组患者的第1秒用力呼气容积、第1秒用力呼气容积占预计值的百分比比较差异均无显著性(P>0.05)。三组患者的镇静成功率均为100.00%,三组患者的苏醒时间、检查时间比较差异均无显著性(P>0.05)。A组和B组患者的呼吸抑制、气道痉挛发生率均显著低于C组(P<0.05)。结论 瑞马唑仑联合舒芬太尼应用于做纤维支气管镜检查患者的镇静效果良好,可显著减轻患者的应激反应,降低呼吸抑制和气道痉挛的发生率。

Objective To investigate the effects of remazolam combined with sufentanil on sedation success,stress response and pulmonary function in patients undergoing fiberoptic bronchoscopy.Method 129 patients undergoing fiberoptic bronchoscopy admitted to our hospital from January to December 2022 were selected as the study objects.They were divided into three groups by random number table method,with 43 patients in each group.Group A was given remazolam combined with sufentanil,and group B was given remazolam combined with fentanyl,and group C was given remazolam combined with remifentanil.The hemodynamic level and degree of sedation of the three groups were compared and analyzed before the examination(T_(1)),at the time of the examination to the glottis(T_(2)),at the time of the examination to the prosopa(T_(3)),and at the end of the examination(T_(4)).The stress response indexes and pulmonary function before and after the examination,recovery time,examination time,success rate of sedation,and the occurrence of adverse reactions during and after the examination of the three groups were compared and analyzed.Result At T_(1),T_(2),T_(3) and T_(4),there were no significant differences in HR,MAP and BIS among the three groups(P>0.05).At T_(2),T_(3),the OAA/S score in group A was significantly lower than that in group B and group C(P<0.05).At the end of examination,the serum levels of AT-Ⅱ,ALD in group A were significantly lower than those in group B and group C(P<0.05),and group B was significantly lower than group C(P<0.05).Before examination,10min after resuscitation and 6h after examination,there were no significant differences in the FEV1 and FEV1%among the three groups(P>0.05).The success rate of sedation among the three groups was 100.00%,and there were no significant differences in the recovery time and examination time among the three groups(P>0.05).The incidence of respiratory depression and airway spasm in group A and group B was significantly lower than that in group C(P<0.05).Conclusion Remazolam combined with sufentanil applied to patients undergoing fiberoptic bronchoscopy showed good sedation,low effect on stress response,low incidence of respiratory depression and airway spasm.