全身麻醉下超声支气管镜引导针吸活检术的临床应用价值

发布时间：2018-04-17 20:34

本文选题：全身麻醉 + 超声支气管镜引导下针吸活检术　；参考：《中国内镜杂志》2017年09期

【摘要】：目的探讨全身麻醉(静脉麻醉联合喉罩)下行超声支气管镜引导经支气管透壁针吸活检术(EBUS-TBNA)的应用价值。方法纳入2015年6月-2016年10月在该院呼吸内镜中心进行的103例EBUS-TBNA的患者,随机分为局麻组和全麻组,全麻组以静脉麻醉联合喉罩进行麻醉,局麻组以常规丁卡因局部麻醉,回顾性分析两组患者每例平均穿刺针数、诊断率、操作时间、并发症及舒适度方面的差异。结果全麻组平均每例穿刺针数5.6针,局麻组3.1针;全麻组诊断率94.12%,局麻组诊断率78.85%,两组诊断率差异有统计学意义(χ~2=5.11,P=0.024);全麻组平均操作时间(14.61±1.52)min,局麻组平均操作时间(32.52±4.14)min,两组比较差异有统计学意义(t=29.01,P=0.000);全麻组术中出血人数及术中呛咳人数均低于局麻组(χ~2=4.31、103.00,P=0.038、0.000)。结论全麻下进行EBUS-TBNA诊断率高,操作时间短,无痛、舒适度高且操作风险降低,值得临床推广。
[Abstract]:Objective to investigate the value of EBUS-TBNA-guided transbronchial needle aspiration under general anesthesia (intravenous anesthesia combined with laryngeal mask).Methods from June 2015 to October 2016, 103 patients with EBUS-TBNA were randomly divided into local anesthesia group and general anesthesia group. The general anesthesia group was anesthetized by intravenous anesthesia combined with laryngeal mask, and the local anesthesia group was treated with routine tetracaine local anesthesia.The average number of puncture needles, diagnostic rate, operation time, complications and comfort were analyzed retrospectively.Results the average number of puncture needles per case was 5.6 in the general anesthesia group and 3.1 in the local anesthesia group.The diagnostic rate of general anesthesia group was 94.12, and that of local anesthesia group was 78.85. The difference between the two groups was statistically significant (蠂 ~ 2 / 5. 11), the mean operating time of general anesthesia group was 14.61 卤1.52min, the mean operating time of local anesthesia group was 32.52 卤4.14 min, the difference between the two groups was statistically significant, and the number of bleeding in general anesthesia group was significantly different.The number of cough choking during operation was lower than that in the local anesthesia group (蠂 ~ 2 = 4.31103.00).Conclusion the diagnosis rate of EBUS-TBNA under general anesthesia is high, the operation time is short, painless, the comfort is high and the operational risk is reduced, so it is worth popularizing.
【作者单位】：第四军医大学唐都医院呼吸与危重症医学科;第四军医大学唐都医院麻醉科;
【基金】：国家公益性行业科研专项(No:201402024)
【分类号】：R614.2

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