摘要
目的：探讨芬太尼、咪达唑仑静脉麻醉在尘肺患者肺泡灌洗术中的应用价值。方法将47例接受肺泡灌洗术的尘肺的患者随机分为静脉麻醉组19例和表面麻醉组28例，静脉麻醉组在局部使用利多卡因的基础上，静脉使用芬太尼、咪达唑仑麻醉后行肺泡灌洗术；表面麻醉组局部使用利多卡因气雾剂麻醉后直接行肺泡灌洗术；比较两组的操作成功率、舒适度、术中患者的反应，监测记录两组患者术前、术中（同时点，置镜后5 min）的血压、心率、血氧饱和度，并比较分析。结果静脉麻醉组操作成功率（100％）高于表面麻醉组（93％）；舒适度比较：静脉麻醉组优于表面麻醉组，差异有统计学意义（Z＝－3．415，P＜0．05）；术中患者的反应：静脉麻醉组不良反应较少、再次灌洗依从性高；两组术前、术中监测结果比较：两组术前比较，差异无统计学意义（P＞0．05）；两组术中比较：静脉麻醉组收缩压、心率低于同时点的表面麻醉组，差异有统计学意义（P＜0．05），血氧饱和度比较差异无统计学意义（P＞0．05）；静脉麻醉组术中与术前比较，差异无统计学意义（P＞0．05）；表面麻醉组术中与术前比较，收缩压、心率明显高于术前，差异有统计学意义（P＜0．05），血氧饱和度比较差异无统计学意义（P＞0．05）。结论开展芬太尼、咪达唑仑静脉麻醉下行支气管肺泡灌洗术，操作成功率高，术中舒适性好，不良反应少，且呼吸循环系统稳定，应用安全，值得推广运用。
Objective To explore the effect of fentanyl and midazolam intravenous anesthesia in bronchoalveolar lavage in pneumoconiosis patients .Methods A total of 47 pneumoconiosis patients were divided into intravenous anesthesia group ( n=19 ) and surface anesthesia group ( n=28 ) .The intravenous anesthesia group used fentanyl and midazolam intravenous anesthesia based on local use of lidocaine , the surface anesthesia group only used lidocaine aerosol anesthesia .The success rate of operation , comfort and patients′reaction in two groups were compared .The blood pressure ( BP ) , heart rate ( HR ) and oxygen saturation ( SpO2 ) of patients in two groups were monitored before and during the operation .Results The success rate of operation in intravenous anesthesia group was higher than that in surface anesthesia group ( 100% vs 93%) . The comfort in intravenous anesthesia group was better than that in surface anesthesia group , and the difference was statistically significant ( Z =-3.415, P <0.05 ).The patients′adverse reaction was less and the compliance was higher when lavage again in intravenous anesthesia group .There was no significant difference in monitoring indexes between two groups before lavage (P>0.05).The BP and HR were lower in intravenous anesthesia group than those in surface anesthesia group at the same time point during lavage , and the differences were statistically significant (P<0.05).There was no significant difference in SpO 2 between two groups (P>0.05).There was no significant difference in monitoring indexes before and during lavage in intravenous anesthesia group (P>0.05).During the operation, the systolic pressure and HR were higher than before in surface anesthesia group, and the differences were statistically significant (P<0.05).There was no significant difference in SpO2 before and during lavage (P >0.05).Conclusions The application of fentanyl and midazolam intravenous anesthesia in bronchoalveolar lavage in pneumoconiosis patients can increase the success rate of operation and
出处
《中华现代护理杂志》
2016年第19期-,共4页
Chinese Journal of Modern Nursing
基金
国家职业病临床重点专科建设项目( WY2011873)；2014年深圳市卫生计生委立项课题
关键词
芬太尼
咪达唑仑
静脉麻醉
尘肺
肺泡灌洗术
Fentanyl
Midazolam
Intravenous anesthesia
Pneumoconiosis
Bronchoalveolar lavage
