摘要
目的观察无痛镇静麻醉对高血压患者支气管内超声引导下经支气管针吸活检(EBUS-TBNA)血压的影响。方法选取2016年1月～2017年12月南京医科大学附属江宁医院呼吸内科收治的胸部强化CT示纵隔及肺门占位病变的高血压患者70例,其中40例患者在无痛镇静麻醉下行EBUS-TBNA检查(PR组,n=40),30例在局部麻醉下行EBUS-TBNA检查(L组,n=30)。观察采取两种麻醉方式检查时,两组患者血压、心率、血氧饱和度的变化,并对麻醉效果、检查中患者的主观感受和不良反应进行评价。结果 L组患者在检查中、检查后的血压与麻醉前的血压比较均有所上升,差异有统计学意义(P <0.05),PR组患者在检查中、检查后的血压与麻醉前的血压比较均有所下降,差异有统计学意义(P <0.05);PR组麻醉效果显著优于L组,确诊率明显高于L组,取材不满意率明显低于L组,差异均有统计学意义(均P <0.05);与L组比较,PR组在检查中更易出现心动过缓,两组均未出现其他严重并发症。结论与局部麻醉比较,无痛镇静麻醉能显著降低患者术中或术后血压,更加适用于高血压患者EBUS-TBNA检查。
Objective To observe the effect of painless sedation and anesthesia on blood pressure in patients with hypertension by endobronchial ultrasound-guided transbronchial needle aspiration biopsy(EBUS-TBNA).Methods From January 2016 to December 2017,70 cases of hypertension patients with mediastinal and hilar occupying lesions on chest enhanced CT admitted to the Department of Respiratory Medicine of Jiangning Hospital Affiliated to Nanjing Medical University were selected.EBUS-TBNA examination was performed in 40 patients under painless sedation and anesthesia(PR group,n=40),and EBUS-TBNA examination was performed in 30 patients under local anesthesia(L group,n=30).The changes of blood pressure,heart rate and blood oxygen saturation in the two groups were observed when the two anesthesia methods were used for examination,and the anesthetic effect,subjective feelings and adverse reactions of the patients in the examination were evaluated.Results Blood pressure of patients in the L group increased during and after examination compared with that before anesthesia,and the difference was statistically significant(P<0.05).The blood pressure of patients in the PR group decreased during and after the examination compared with that before anesthesia,and the difference was statistically significant(P<0.05).The anesthesia effect of PR group was significantly better than that of L group,the diagnosis rate was significantly higher than that of L group,and the satisfaction rate of sampling was significantly lower than that of L group,the difference was statistically significant(P<0.05).Bradycardia was more common in PR group than in L group,and no other serious complications were found in both groups.Conclusion Compared with local anesthesia,painless sedation anesthesia can significantly reduce patients′intraoperative or postoperative blood pressure,which is more suitable for ebus-tbna examination in patients with hypertension.
作者
晋发
杨健
朱颖
杨旸
武良权
张巧
刘盼盼
张秀伟
JING Fa;YANG Jian;ZHU Ying;YANG Yang;WU Liangquan;ZHANG Qiao;LIU Panpan;ZHANG Xiuwei(Department of Respiratory Medicine,the Affiliated Jiangning Hospital of Nanjing Medical University,Jiangsu Province,Nanjing 211100,China)
出处
《中国医药导报》
CAS
2019年第4期108-111,共4页
China Medical Herald
基金
江苏省卫生计生委科研课题项目(YG201502)
关键词
超声引导下经支气管针吸活检
高血压
利多卡因
丙泊酚
瑞芬太尼
Endobronchial ultrasound-guided transbronchial needle aspiration
Hypertension
Lidocaine
Propofol
Remifentanil
