摘要
目的调查国内无痛气管镜诊疗麻醉开展的情况.方法2018年12月至2019年2月,采用自行设计的调查表,通过微信向调查范围内医院麻醉科相关人员发起电子问卷调查.调查主要包括3方面内容:医院基本信息、气管镜诊疗麻醉开展情况及具体管理方案.结果总共向326家医院发出参与调研答卷,有261家医院回复,回复率为80.1%.参与问卷的261家中,有34家回复无相关疾病,故有效问卷为227份,答卷有效率为87.0%.其中三级医院161家,二级医院66家,构成比为70.9%∶29.1%.无痛气管镜诊疗平均开展率为34.8%,其中北京地区最高为54.0%,河北省最低为27.5%.三级医院中无痛气管镜诊疗开展率高于二级医院(P<0.05).各地区近5年人均GDP与无痛气管镜诊疗的开展呈正相关.未开展无痛气管镜诊疗的医院中,开展无痛气管镜诊疗最大困难前3位原因是人员不足、技术不足和医院管理条件的限制.与采用局麻强化比较,采用喉罩通气全麻和监护麻醉医院数较多(P<0.05).在无痛气管镜诊疗开展的场所方面,与在监护室或病房比较,选择在手术室和内镜中心的医院数较多(P<0.05);与在手术室比较,在内镜中心开展此类诊疗的医院数较多(P<0.05).麻醉设备应用方面,BIS监测在术中应用的医院数比麻醉机、微量泵和监护仪的应用少(P<0.05).无痛气管镜诊疗用药方面,与镇静和镇痛药物比较,肌松药、吸入和其它类型药物应用医院数少(P<0.05);在镇静药物中,与其它静脉麻醉药物比较,丙泊酚应用医院数多(P<0.05);在镇痛药物中,芬太尼、舒芬太尼和瑞芬太尼应用医院数比较差异无统计学意义(P>0.05);与地氟醚比较,七氟醚应用医院数多(P<0.05);在肌松药中,罗库溴铵、顺阿曲库铵和维库溴铵应用医院数比较差异无统计学意义(P>0.05).结论目前我国无痛气管镜诊疗开展率较低,继续开展的最大困难为人员不足.喉罩或监护麻醉下无痛气管镜
Objective To investigate the development of painless bronchoscope diagnosis and treatment under general anesthesia in five provinces and cities in China.Methods From December 2018 to February 2019,a self-designed electronic questionnaire was sent to related personnels in a department of anesthesiology in hospitals within the range of survey through the WeChat platform.The survey mainly included three aspects:basic information of hospital,development of bronchoscope diagnosis and treatment under general anesthesia and the specific management plan.Results Questionnaires were sent to 326 hospitals in total,and 261 hospitals responded with a response rate of 80.06%.Among the 261 hospitals involved in the survey,34 hospitals responded that no related diseases were found,and thus the number of valid questionnaires was 227,and the rate of valid questionnaires was 87.0%.Among the 261 hospitals,161 hospitals were tertiary hospitals,and 66 hospitals were secondary hospitals,with a constituent ratio of 70.9% to 29.1%.The average development rate of painless bronchoscopy was 34.8%,the highest rate was 54.0% in Beijing,and the lowest rate was 27.5% in Hebei province.The average development rate of painless bronchoscopy was significantly higher in tertiary hospitals than in secondary hospitals(P<0.05).The per capita GDP in each region in the past five years was positively correlated with the development of painless bronchoscopic surgery.In hospitals where painless bronchoscope diagnosis and treatment was not performed,the top three reasons for the greatest difficulties in carrying out painless bronchoscopy were insufficient personnel,inadequate technologies and restrictions on hospital management conditions.The number of hospitals using general anesthesia with laryngeal mask ventilation and monitoring anesthesia was larger than that of hospitals using local anesthesia(P<0.05).In terms of the places where painless bronchoscope diagnosis and treatment was carried out,the number of hospitals selecting the operating room and endos
作者
刘亮
耳建旭
韩建阁
Liu Liang;Er Jianxu;Han Jiange(Department of Anesthesiology,Tianjin Chest Hospital,Tianjin 300222,China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2019年第7期775-779,共5页
Chinese Journal of Anesthesiology
关键词
支气管镜检查
调查和问卷
Bronchoscopy
Surveys and questionnaires
