困难气道纤维支气管镜气管插管的麻醉研究

发布时间：2018-04-17 05:15

本文选题：右美托咪定 + 插管法　；参考：《解放军医药杂志》2016年09期

【摘要】：目的观察右美托咪定联合瑞芬太尼在困难气道患者纤维支气管镜气管插管中的临床效果。方法回顾性分析2014年1月—2015年12月行纤维支气管镜气管插管的困难气道患者100例,根据用药方法分为观察组和对照组各50例。两组均给予瑞芬太尼稀释液静脉泵入,观察组在此基础上给予右美托咪定。比较两组患者入室后(T0)、药物输注完毕(T1)、纤维支气管镜插管前(T2)、插管即刻(T3)、插管后5 min(T4)的平均动脉压(MAP)、心率(HR)、血氧饱和度(Sp O2)以及Ramsay评分,并观察术后不良反应情况。结果观察组MAP、HR在T1、T2、T3时低于对照组(P0.05)。两组Sp O2变化差异无统计学意义(P0.05)。与T0、T1比较,观察组T2、T3、T4时Ramsay评分升高(P0.05);对照组T2、T3降低,T4时点升高(P0.05);且在T2、T3、T4时观察组高于对照组(P0.05)。观察组不良反应发生率低于对照组(P0.05)。结论右美托咪定联合瑞芬太尼对困难气道患者纤支镜插管的麻醉效果较好,安全性较高。
[Abstract]:Objective to observe the clinical effect of dexmetomidine combined with remifentanil on tracheal intubation under fibrobronchoscope in patients with difficult airway.Methods from January 2014 to December 2015, 100 cases of difficult airway intubation with fiberoptic bronchoscope were analyzed retrospectively. According to the medication methods, the patients were divided into two groups: the observation group (n = 50) and the control group (n = 50).Both groups were injected with remifentanil diluted solution via vein, and the observation group received dexmetomidine on this basis.The mean arterial pressure (MAPP), heart rate (HRT), blood oxygen saturation (SpO2) and Ramsay score were compared between the two groups. The mean arterial pressure (MAPP), heart rate (HR), blood oxygen saturation (SpO2) and Ramsay score were compared between the two groups.Results the MAPHR in the observation group was lower than that in the control group at T _ 1 and T _ 2 T _ 3.There was no significant difference in SPO 2 between the two groups (P 0.05).Compared with T0 T 1, the Ramsay score of the observation group was higher than that of the control group at T 2, T 3 and T 4, while that of the control group was higher than that of the control group at the time point of decrease of T 2 T 3 and T 4, and the observation group was higher than that of the control group at T 2 T 3 T 4.The incidence of adverse reactions in the observation group was lower than that in the control group (P 0.05).Conclusion dexmetomidine combined with remifentanil is effective and safe in the treatment of bronchofiberscope intubation in patients with difficult airway.
【作者单位】：青岛市胶州中心医院麻醉科;
【分类号】：R614.21

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