摘要
目的：探讨异丙酚复合芬太尼麻醉用于支气管镜行气道异物取出的临床应用。方法：67例病人随机分成二组．A组32例为局麻组，用2％利多卡因予咽部、气管表麻。B组35例为全麻组，予异丙酚（2±0．56）mg／kg，芬太尼50—100μg，术中静脉推注维持麻醉。术申严密监护患者反应、体动、面色、生命体征，血氧饱和度。结果：B组治愈率较A组高（P〈0．05）。A组SBP和DBP的波动明显大于B组，两组比较差异有统计学意义（P〈0．05）。此外，B组病人脉搏、氧饱和度（SpO2）较术前有所降低，但无统计学意义（P〉0．05）。在操作过程中发生体动、呛咳、呼吸困难的反应和出血明显低于局麻组，两组比较差异有统计学意义（P〈0．01）。结论：在无病支气管镜下行气道异物取出术较局麻组镇静效果显著，安全可靠、无痛苦，治愈率高，并发症少，值得推广。
Objective： Make a study of clinical application of indolent bronchoscope on removing a foreign body out from the trachea. Method ： Divided 67 patients into two groups - Group A and Group B. 32 patients of Group A, general anaesthesia, were injected 2% Lidocaine into pharyngeal and trachea surface. 35 patients of Group B, local anaesthesia, were injected propofol （2 ± 0.56mg/kg） and fentany （50 - 100μg）, maintaining anaesthesia by intravenous injection. Watched carefully the patients＇body movements, complexions, life symptoms and oxygen saturations. Result： The cure rate of Group B was higher（P 〈0.05） than Group A. SBP ＆ DBP＇s fluctuation of Group A was bigger than Group B. The difference between the two groups had a statistical significance （ P 〈0. 05 ）. The pulses of Group B were slower and the degrees of saturation（ SpO2 ） of Group B were lower after the operation. But they had no statistical significance（ P 〉 0. 05 ）. In the procedure, body movements, coughs, hard - breaths and hemorrhages of Group A were fewer than Group B. The difference had a statistical significance（P 〈 0.01 ）. Conclusion Removing a foreign body away with indolent bronchoscope is safe and reliable, painless and convenient. The cure rate is higher and complications are fewer, too. It is worth popularizing.
关键词
支气管镜
异丙酚
气道异物
取出
bronchoscope
propofol
a foreign body
remove out
