摘要
目的:探讨喉罩无痛支气管镜检查在老年患者中的可行性及安全性。方法:按照自愿原则,对50例喉罩无痛支气管镜检查(无痛组)和同期45例行常规支气管镜检查(常规组)的老年患者进行分析,观察两组检查成功率、生命体征变化、并发症和愿意再次接受检查的情况。结果:无痛组检查成功率100%,优于常规组(84. 44%)(P<0. 05);常规组过声门时(T_1)、术中(T_2)及术后(T_3)患者心率、呼吸频率、血压比无痛组高(P<0. 01),血氧饱和度(SpO_2)低于无痛组(P<0. 01);常规组患者体动、呛咳、手术操作不良记忆高于无痛组(P<0. 01),愿意再次接受检查患者低于无痛组(P<0. 01)。结论:喉罩无痛支气管镜检查技术可提高老年患者检查成功率,减轻患者痛苦,是一种舒适、安全的检查方法。美国麻醉师协会(ASA)分级4级患者应注意掌握麻醉的深度、器官功能的保护,避免出现严重并发症。
Objective:To assess the feasibility and safety of painless flexible fibreoptic bronchoscopy via laryngeal mask airway in elderly patients.Methods:Ninety-five elderly patients were recruited,and allocated to group of painless flexible fibreoptic bronchoscopy(painless group,n=50)and conventional bronchoscopy(conventional group,n=45)by patient′s decision.The two groups were observed and compared regarding the successful rate,changes of vital signs in examination,adverse events and willingness to accept re-examination.Results:The successful rate of bronchoscopy was 100%in painless group versus 84.44%in conventional group(P<0.05).Patients in the conventional group had significantly elevated heart rate(HR),respiratory frequency(RR)and blood pressure(BP)than those in the painless group at the time of the bronchoscope passing through glottis(T 1)as well as in examination(T 2)and post-operation(T 3)(P<0.01),and had lower level of pulse oxygen saturation(SpO 2)(P<0.01).The body movement,bucking reaction and undesirable memory were significantly higher in conventional group than in painless group(P<0.01),and patients in painless group were willing to accept re-examination when needed(P<0.01).Conclusion:Painless flexible fibreoptic bronchoscopy via laryngeal mask airway can be a safe procedure in elderly patients because of its successful rate as well as alleviation of pain and less discomfort in examination.However,attention should be paid to patients of ASA-4 in the depth of anesthesia for protection of organ function and reduction of complications.
作者
徐裕丰
李乾兵
陈俊
汪东学
童亚玲
XU Yufeng;LI Qianbing;CHEN Jun;WANG Dongxue;TONG Yaling(Department of Respiratory Medicine,The First People′s Hospital of Anqing,Anqing 246003,China)
出处
《皖南医学院学报》
CAS
2018年第6期554-557,共4页
Journal of Wannan Medical College
基金
安庆市医学重点学科建设计划
关键词
支气管镜检查
喉罩
无痛检查法
老年患者
bronchoscopy
laryngeal mask
painless examination
elderly patients
