BACKGROUND Fibrobronchoscopy is a common adjunct tool that requires anesthesia and is widely used in the diagnosis and treatment of various respiratory diseases.However,current anesthesia methods,such as spray,nebuliz...BACKGROUND Fibrobronchoscopy is a common adjunct tool that requires anesthesia and is widely used in the diagnosis and treatment of various respiratory diseases.However,current anesthesia methods,such as spray,nebulized inhalation,and cricothyroid membrane puncture,have their own advantages and disadvantages.Recently,studies have shown that bronchoscopic direct-view glottis anesthesia is a simple and inexpensive method that shortens the examination time and provides excellent anesthetic results.AIM To evaluate the effectiveness of bronchoscopic direct vision glottis anesthesia for bronchoscopy.METHODS The study included 100 patients who underwent bronchoscopy during thoracic surgery.A random number table method was used to divide the patients into control and observation groups(50 patients each).The control and observation groups were anesthetized using the nebulized inhalation and bronchoscopic direct vision glottis method,respectively.Hemodynamic indices[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),and oxygen saturation(SpO_(2))before(T1),5 min after anesthesia(T2),and at the end of the operation(T3)]serum stress hormone indices[norepinephrine(NE),epinephrine(E),adrenocorticotropic hormone(ACTH),and cortisol(Cor)before and after treatment]were compared between the 2 groups.Adverse effects were also RESULTS At T2 and T3,SBP,DBP,and HR were lower in the observation group than the control group,whereas SpO_(2) was higher than the control group[(119.05±8.01)mmHg vs(127.05±7.83)mmHg,(119.35±6.66)mmHg vs(128.39±6.56)mmHg,(84.68±6.04)mmHg vs(92.42±5.57)mmHg,(84.53±4.97)mmHg compared to(92.57±6.02)mmHg,(74.25±5.18)beats/min compared to(88.32±5.72)beats/min,(74.38±5.31)beats/min compared to(88.42±5.69)beats/min,(97.36±2.21)%vs(94.35±2.16)%,(97.42±2.36)%vs(94.38±2.69%],with statistically significant differences(all P<0.05).After treatment,NE,E,ACTH,and Cor were significantly higher in both groups than before treatment,but were lower in the observation group than in the control group[(68.25±8.87)ng/mL vs(93.35±14.00)ng/mL,(53.59±5.89)ng/mL vs(82.32±10.70)ng/mL,(14.32±1.58)pg/mL vs(20.35±3.05)pg/mL,(227.35±25.01)nmol/L vs(322.28±45.12)nmol/L],with statistically significant differences(all P<0.05).The incidence of adverse reactions was higher in the control group than in the observation group[12.00%(12/50)vs 6.00%(3/50)](P<0.05).CONCLUSION The use of bronchoscopic direct vision glottis anesthesia method for bronchoscopy patients is beneficial for stabilizing hemodynamic indices during bronchoscopy and reducing the level of patient stress,with good safety and practicality.展开更多
目的分析不同麻醉方式在胎儿窘迫情况下施行剖宫产对母婴结局的影响,为临床麻醉选择提供科学依据。方法回顾分析2022年1月至2025年6月在厦门市妇幼保健院因胎儿窘迫而接受剖宫产的产妇的临床资料,共287例,根据麻醉方式的不同将其分为A组...目的分析不同麻醉方式在胎儿窘迫情况下施行剖宫产对母婴结局的影响,为临床麻醉选择提供科学依据。方法回顾分析2022年1月至2025年6月在厦门市妇幼保健院因胎儿窘迫而接受剖宫产的产妇的临床资料,共287例,根据麻醉方式的不同将其分为A组(全身麻醉组30例)、B组(连续硬膜外麻醉组124例),C组(腰硬联合麻醉组133例),比较3组的母婴结局指标。结果连续硬膜外麻醉组在多个关键指标上表现优于全身麻醉和腰硬联合麻醉,尤其是新生儿Apgar评分较高、出生1 min和5 min Apgar评分≤7分的比例以及产后住院天数都小于腰硬联合麻醉组和全身麻醉组,但术后贫血的发生率较高。全身麻醉组麻醉开始及手术开始到胎儿娩出时长最短,但产妇转ICU比例和术中高血压发生率以及新生儿窒息和湿肺的发生率较高、新生儿Apgar评分较低。腰硬联合麻醉组比起全身麻醉组和连续硬膜外麻醉组产前产后血红蛋白差值较小,但血管活性药的应用较多、术后住院时间较长。结论在胎儿窘迫的紧急情况下施行剖宫产时,已行硬膜外分娩镇痛的产妇,选择连续硬膜外麻醉较为安全有效,能够改善母婴结局。展开更多
目的探讨基于SimMan 3G模拟人情景模拟教学在麻醉专业本科临床实习阶段入科教育的应用效果。方法选择2023年10月在广西医科大学第一附属医院麻醉手术中心实习的麻醉专业本科生22名。采用随机数字表法将学员分为案例教学组(n=11)和模拟...目的探讨基于SimMan 3G模拟人情景模拟教学在麻醉专业本科临床实习阶段入科教育的应用效果。方法选择2023年10月在广西医科大学第一附属医院麻醉手术中心实习的麻醉专业本科生22名。采用随机数字表法将学员分为案例教学组(n=11)和模拟教学组(n=11),案例教学组采用案例教学法培训,模拟教学组采用基于SimMan 3G模拟人情景模拟教学法培训,两组学员培训内容均为支气管痉挛和用药错误,培训后进行理论考核、技能考核和教学满意度评价。记录和比较两组学员的理论考核成绩、技能考核成绩及满意度。结果与案例教学组比较,模拟教学组学员技能考核成绩较高:临床思维(17.2±2.6 vs 14.0±2.0)分(P<0.05)、临床操作(17.7±2.6 vs 15.0±3.1)分(P<0.05)、团队合作(15.4±3.5 vs 12.2±2.6)分(P<0.05)、沟通能力(14.5±3.5 vs 11.3±2.3)分(P<0.05)、应变能力(12.7±2.6 vs 10.0±2.2)分(P<0.05)、总分(77.7±10.3 vs 62.7±9.0)分(P<0.05)。两组学员理论考核成绩和教学满意度比较,差异无统计学意义(P>0.05)。结论基于SimMan 3G模拟人实施的情景模拟教学能够更好地提升麻醉专业本科生处置麻醉危机事件的实际操作能力和综合临床能力。展开更多
基金Hebei Science and Technology Program,No.162777232(to Xing SS).
文摘BACKGROUND Fibrobronchoscopy is a common adjunct tool that requires anesthesia and is widely used in the diagnosis and treatment of various respiratory diseases.However,current anesthesia methods,such as spray,nebulized inhalation,and cricothyroid membrane puncture,have their own advantages and disadvantages.Recently,studies have shown that bronchoscopic direct-view glottis anesthesia is a simple and inexpensive method that shortens the examination time and provides excellent anesthetic results.AIM To evaluate the effectiveness of bronchoscopic direct vision glottis anesthesia for bronchoscopy.METHODS The study included 100 patients who underwent bronchoscopy during thoracic surgery.A random number table method was used to divide the patients into control and observation groups(50 patients each).The control and observation groups were anesthetized using the nebulized inhalation and bronchoscopic direct vision glottis method,respectively.Hemodynamic indices[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),and oxygen saturation(SpO_(2))before(T1),5 min after anesthesia(T2),and at the end of the operation(T3)]serum stress hormone indices[norepinephrine(NE),epinephrine(E),adrenocorticotropic hormone(ACTH),and cortisol(Cor)before and after treatment]were compared between the 2 groups.Adverse effects were also RESULTS At T2 and T3,SBP,DBP,and HR were lower in the observation group than the control group,whereas SpO_(2) was higher than the control group[(119.05±8.01)mmHg vs(127.05±7.83)mmHg,(119.35±6.66)mmHg vs(128.39±6.56)mmHg,(84.68±6.04)mmHg vs(92.42±5.57)mmHg,(84.53±4.97)mmHg compared to(92.57±6.02)mmHg,(74.25±5.18)beats/min compared to(88.32±5.72)beats/min,(74.38±5.31)beats/min compared to(88.42±5.69)beats/min,(97.36±2.21)%vs(94.35±2.16)%,(97.42±2.36)%vs(94.38±2.69%],with statistically significant differences(all P<0.05).After treatment,NE,E,ACTH,and Cor were significantly higher in both groups than before treatment,but were lower in the observation group than in the control group[(68.25±8.87)ng/mL vs(93.35±14.00)ng/mL,(53.59±5.89)ng/mL vs(82.32±10.70)ng/mL,(14.32±1.58)pg/mL vs(20.35±3.05)pg/mL,(227.35±25.01)nmol/L vs(322.28±45.12)nmol/L],with statistically significant differences(all P<0.05).The incidence of adverse reactions was higher in the control group than in the observation group[12.00%(12/50)vs 6.00%(3/50)](P<0.05).CONCLUSION The use of bronchoscopic direct vision glottis anesthesia method for bronchoscopy patients is beneficial for stabilizing hemodynamic indices during bronchoscopy and reducing the level of patient stress,with good safety and practicality.
文摘目的分析不同麻醉方式在胎儿窘迫情况下施行剖宫产对母婴结局的影响,为临床麻醉选择提供科学依据。方法回顾分析2022年1月至2025年6月在厦门市妇幼保健院因胎儿窘迫而接受剖宫产的产妇的临床资料,共287例,根据麻醉方式的不同将其分为A组(全身麻醉组30例)、B组(连续硬膜外麻醉组124例),C组(腰硬联合麻醉组133例),比较3组的母婴结局指标。结果连续硬膜外麻醉组在多个关键指标上表现优于全身麻醉和腰硬联合麻醉,尤其是新生儿Apgar评分较高、出生1 min和5 min Apgar评分≤7分的比例以及产后住院天数都小于腰硬联合麻醉组和全身麻醉组,但术后贫血的发生率较高。全身麻醉组麻醉开始及手术开始到胎儿娩出时长最短,但产妇转ICU比例和术中高血压发生率以及新生儿窒息和湿肺的发生率较高、新生儿Apgar评分较低。腰硬联合麻醉组比起全身麻醉组和连续硬膜外麻醉组产前产后血红蛋白差值较小,但血管活性药的应用较多、术后住院时间较长。结论在胎儿窘迫的紧急情况下施行剖宫产时,已行硬膜外分娩镇痛的产妇,选择连续硬膜外麻醉较为安全有效,能够改善母婴结局。
文摘目的探讨基于SimMan 3G模拟人情景模拟教学在麻醉专业本科临床实习阶段入科教育的应用效果。方法选择2023年10月在广西医科大学第一附属医院麻醉手术中心实习的麻醉专业本科生22名。采用随机数字表法将学员分为案例教学组(n=11)和模拟教学组(n=11),案例教学组采用案例教学法培训,模拟教学组采用基于SimMan 3G模拟人情景模拟教学法培训,两组学员培训内容均为支气管痉挛和用药错误,培训后进行理论考核、技能考核和教学满意度评价。记录和比较两组学员的理论考核成绩、技能考核成绩及满意度。结果与案例教学组比较,模拟教学组学员技能考核成绩较高:临床思维(17.2±2.6 vs 14.0±2.0)分(P<0.05)、临床操作(17.7±2.6 vs 15.0±3.1)分(P<0.05)、团队合作(15.4±3.5 vs 12.2±2.6)分(P<0.05)、沟通能力(14.5±3.5 vs 11.3±2.3)分(P<0.05)、应变能力(12.7±2.6 vs 10.0±2.2)分(P<0.05)、总分(77.7±10.3 vs 62.7±9.0)分(P<0.05)。两组学员理论考核成绩和教学满意度比较,差异无统计学意义(P>0.05)。结论基于SimMan 3G模拟人实施的情景模拟教学能够更好地提升麻醉专业本科生处置麻醉危机事件的实际操作能力和综合临床能力。
