摘要
目的：评价右美托咪定联合地佐辛用于纤维支气管镜（纤支镜）检查的效果。方法择期行纤支镜检查患者40例，ASAⅠ级或Ⅱ级，采用数字表法随机分为两组：右美托咪定复合地佐辛组（A 组）和0．9％氯化钠注射液复合地佐辛对照组（B 组），每组20例。两组术前均使用2％利多卡因超声雾化吸入行局部表面麻醉。记录两组患者给药前（T1）、静脉泵注药物15 min 后（T2）、纤支镜入声门即刻（T3）、纤支镜入声门后3 min（T4）、检查结束后患者完全清醒时（T5）的平均动脉压（MAP）、心率（HR）和脉搏血氧饱和度（SpO2）。记录两组患者检查时间、术后不适度视觉模拟评分（VAS）、重复检查的依从性评分。结果40例患者均顺利完成纤支镜检查。A 组检查时间、术后 VAS 评分、重复检查的依从性评分分别为（8±2）min、（2±2）分、（3±2）分，均低于 B 组的（10±3）min、（7±2）分、（7±3）分（t ＝3．17、10．46、8．78，均 P ＜0．05）。A 组 T3、T4、T5的MAP 分别为（90±10）mmHg、（86±11）mmHg、（81±9）mmHg，较 B 组的（115±15）mmHg、（100±14）mmHg、（96±13）mmHg 降低（t ＝11．93、9．96、7．37，均 P ＝0．00），A 组 T2、T3、T4、T5的 HR 分别为（73±12）次／min、（90±13）次／min、（85±11）次／min、（78±10）次／min，较 B 组的（88±15）次／min、（112±21）次／min、（101±18）次／min、（96±16）次／min 降低（t ＝7．96、16．79、9．58、7．98，均 P ＝0．00）。两组组间各时点脉搏血氧饱和度差异均无统计学意义（均 P ＞0．05）。结论右美托咪定联合地佐辛可安全有效地用于纤支镜检查。
Objective To evaluate the effects of intravenous pump infusion with dexmedetomidine and dezo-cine on flexible fiberoptic bronchoscopy（FFB）.Methods Forty ASA Ⅰ or Ⅱ patients undergoing elective FFB were randomly divided into two groups,20 cases in each group.The intravenous anesthesia group was given dexmedetomi-dine and dezocine（group A）,the control group was given 0.9% sodium chloride injection and dezocine（group B）. All patients received airway local topical anesthesia with 2% lidocaine before the procedure.MAP,HR and SpO2 were continuously monitored and recorded pre -administrion（T1 ,baseline）,15min after pump infusion（T2 ）,immediately and 3 min after intubation（T3 ,T4 ）,after FFB（T5 ）.The persistence time of the procedure was noted.All patients were interviewed for the global tolerance to the procedure,the acceptance of another fiberoptic bronchoscopy and the degree of amnesia.Results All of the forty patients finished FFB successfully.The persistence time,global tolerance to the procedure and the acceptance of another FFB in group A [（8 ±2）min,（2 ±2）points,（3 ±2）points]were signifi-cantly lower than those in group B [（10 ±3）min,（7 ±2）points,（7 ±3）points]（t =3.17,10.46,8.78,all P 〈0.05）.MAP at T3 -5 in group A [（90 ±10）mmHg,（86 ±11）mmHg,（81 ±9）mmHg]were significantly decreased compared with the group B [（115 ±15）mmHg,（100 ±14）mmHg,（96 ±13）mmHg]（t =11.93,9.96,7.37,all P =0.00）.HR at T2 -5 in group A [（73 ±12）times/min,（90 ±13）times/min,（85 ±11 ）times/min,（78 ± 10）times/min]were significantly decreased compared with those in the control group [（88 ±15）times/min,（112 ± 21）times/min,（101 ±18）times/min,（96 ±16）times/min]（t =7.96,16.79,9.58,7.98,all P =0.00）.There were no significant differences in oxygen saturation between the two groups（P 〉0.05）.Conclusion Intravenous pump infusion with dexmedetomidine and dezocine is safe and effective for FFB.
作者
王加芳
陈菁
李进
袁军
朱斌
Wang Jiafang Chen Jing Li Jin Yuan Jun Zhu Bin(Department of Anesthesia, the First Hospital of Wuhan, Wuhan, Hubei 430022, China Department of Respiratory,the First Hospital of Wuhan, Wuhan, Hubei 430022, China Department of Anesthesia, International Hospital of Peking University, Beijing 102206, China)
出处
《中国基层医药》
CAS
2016年第24期3745-3748,共4页
Chinese Journal of Primary Medicine and Pharmacy
