咪达唑仑静脉麻醉与利多卡因局部麻醉联合在纤维支气管镜检查和治疗中的疗效比较

发布时间：2018-02-03 10:50

本文关键词： 纤维支气管镜静脉麻醉咪达唑仑利多卡因　出处：《现代生物医学进展》2016年24期 　论文类型：期刊论文

【摘要】：目的:探讨咪达唑仑静脉麻醉联合利多卡因局部麻醉在纤维支气管镜(FOB)检查和治疗中的疗效。方法:将我院在2013年1月~2014年1月期间需行FOB检查的118例患者随机分为试验组和对照组,各59例,对照组采用利多卡因局部麻醉,试验组患者在局部麻醉基础上予以咪达唑仑0.05 mg/kg。记录麻醉前(T0)、FOB进入咽腔时(T1)、进入声门时(T2)、进入支气管时(T3)的平均动脉压(MAP)、心率(HR)、血氧饱和度(Sp O2),并在各个时间点进行镇静评分,记录检查过程中的不良反应、知晓程度及检查结束后患者的满意度。结果:两组Ramsay评分随时间的麻醉时间延长而逐渐升高,T2、T3时两组间比较差异均有统计学意义(P0.05);试验组T1、T2、T3时MAP、HR、Sp O2较T0时差异无统计学意义(P0.05),试验组T1、T2、T3时点MAP、HR均较对照组低(P0.05),Sp O2均较对照组高,差异有统计学意义(P0.05);试验组的呛咳、躁动、中止检查及操作知晓率均明显低于对照组,而满意率明显高于对照组,差异有统计学意义(P0.05)。结论:咪达唑仑静脉麻醉与利多卡因局部麻醉联合在FOB检查和治疗中可以减轻心血管反应,减少插管反应及操作时的知晓率,安全性较高,值得临床推广应用。
[Abstract]:Objective: to investigate the effect of midazolam intravenous anesthesia combined with local lidocaine anesthesia on fiberoptic bronchoscopy (FOB). Methods: from January 2013 to January 2014, 118 patients with FOB were randomly divided into experimental group and control group. 59 cases in each group were treated with lidocaine local anesthesia. The patients in the experimental group were given midazolam 0.05 mg / kg on the basis of local anesthesia. The mean arterial pressure of FOB in pharynx, glottis and bronchus was T1, T1, T1, T1, T2, T3, HR, SPO _ 2, respectively, when entering the pharynx, entering the glottis, and entering the bronchus (T3). Sedation score was performed at each time point to record the adverse reactions during the examination. Results: the Ramsay score of the two groups increased gradually with the prolongation of anesthesia time. The difference between the two groups at T3 was statistically significant (P 0.05). There was no significant difference between the test group and the T0 group at the time of T _ 1 and T _ 2T _ 3. There was no significant difference between the two groups (P 0.05), and the test group had MAP at the time of T _ 1 and T _ 2T _ 3. HR was higher than that of the control group (P 0.05), and the difference was statistically significant (P 0.05). The rate of cough, restlessness, discontinuance and operation awareness in the test group was significantly lower than that in the control group, while the satisfaction rate was significantly higher than that in the control group. Conclusion: the combination of midazolam intravenous anesthesia and lidocaine local anesthesia can alleviate cardiovascular response in FOB examination and treatment. It is safe to reduce the awareness rate of intubation reaction and operation, so it is worth popularizing in clinic.
【作者单位】：河北省保定市第二中心医院感染性疾病科;
【分类号】：R614
【正文快照】： Chinese Library Classification(CLC):R614 Document code:AArticle ID:1673-6273(2016)4727-04前言纤维支气管镜(fiberoptic bronchoscopy,FOB)检查是呼吸疾病中常用的操作项目,其适用于肺及支气管病变的观察,活体组织取样等[1,2]。普通FOB检查通常是在局部麻醉且患者意识清

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