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喉罩通气在COPD患者无痛纤维支气管镜检查中的应用 被引量:14

Application of laryngeal mask airway in the indolent fiberoptic bronchoscopy for COPD patients
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摘要 目的研究静脉麻醉下喉罩通气在COPD患者无痛纤维支气管镜检查中的有效性与安全性。方法选取2016年10月~2018年3月共86例COPD患者接受无痛纤维支气管镜检查,按随机方法分为A组(喉罩组)、B组(非喉罩组),每组各43例。分别记录入室后(T1),纤支镜通过声门时(T2)、纤支镜插入后3min(T3)、检查结束时(T4)和出室前(T5)5个时点患者的收缩压(SBP)、氧饱和(SpO2)、心率(HR)。记录躁动、呛咳、憋气及氧饱和度低于85%的例数以及操作时间。术后使用视觉模拟量表(VAS)(0~10),评估患者的舒适程度,并调查患者再次行气管镜检查的意愿。结果与A组相比,B组患者检查中HR、SBP在(T2)明显升高,操作过程中SpO2明显下降(P<0.05),不良反应增加(P<0.05)、操作时间明显延长(P<0.01)、舒适度降低(P<0.05)。结论喉罩用于COPD患者无痛纤维支气管镜检查,临床效果满意,安全性高。 Objective To evaluate the effectiveness and safety of fiberoptic bronchoscopy through laryngeal mask airway(LMA)in patients with COPD.Methods From October 2016 to March 2018,a total of 86 COPD patients underwent painless fiberoptic bronchoscopy were randomly divided into two groups:the group A(LMA)and the group B(NLMA),43 cases in each group.The levels of systolic blood pressure(SBP),oxygen saturation(SpO 2)and heart rate(HR)were recorded at 5 time points:T1(after arrival),T2(bronchoscope passed the glottis),T3(3 min after inserting fibrobronchoscope),T4(the end of the examination)and T5(pre-departure).It recorded agitation,coughing,shortness of breath,the times of blood oxygen less than 85%and the scopy duration.Visual analogue scale(VAS)(0~10)was used to assess the patient’s comfort level,and the patient's willingness to undergo a second endoscopy was recorded too.Results Compared with the group A,HR and SBP increased significantly,SpO 2 decreased significantly during operation,the incidence of adverse reactions increased,scopy duration was significantly prolonged,and comfort level decreased significantly in the group B(P<0.05 or P<0.01).Conclusion Laryngeal masks can enhance the safety and efficiency of painless fiberoptic bronchoscopy in patients with COPD.
作者 陈沛锐 洪澜 林燕 吕静 刁明强 CHEN Pei-rui;HONG Lan;LIN Yan;LYU Jing;DIAO Ming-qiang(Department of Thoracic Surgery,Deyang People’s Hospital,Deyang,Sichuan 618000,China)
出处 《临床肺科杂志》 2019年第7期1165-1168,共4页 Journal of Clinical Pulmonary Medicine
基金 四川省卫生和计划生育委员会科研项目(No 16PJ142)
关键词 COPD 纤维支气管镜 喉罩 麻醉 COPD fiberoptic bronchoscope laryngeal mask anesthesia
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