2021 年第 10 期 第 16 卷

右美托咪定联合喉罩置入在无痛电子支气管镜检查中的安全性研究

Safety of dexmedetomidine combined with laryngeal mask airway placement in painless electronic bronchoscopy

作者：李洪图张珂张娜魏艳华路雪曹红云

英文作者：Li Hongtu Zhang Ke Zhang Na Wei Yanhua Lu Xue Cao Hongyun

单位：山东省淄博市市立医院无痛内镜部255400

英文单位：Department of Painless Endoscope Zibo Municipal Hospital Shandong Province Zibo 255400 China

关键词：无痛电子支气管镜检查；喉罩；右美托咪定；生命体征；不良反应

英文关键词：Painlesselectronicbronchoscopy;Laryngealmaskairway;Dexmedetomidine;Vitalsigns;Adversereactions 

• 摘要：

• 目的  探讨右美托咪定联合喉罩置入在无痛电子支气管镜检查中的安全性。方法 选取2019年1—8月于山东省淄博市市立医院行电子支气管镜下肿物活检术的肺部肿物患者96例，采取抽签法随机分为A组、B组、C组，各32例。A组予表面麻醉处理，B组在A组基础上予丙泊酚复合芬太尼静脉麻醉，C组在B组基础上予右美托咪定联合喉罩置入。比较3组患者术前、术中(支气管镜入声门后3 min)生命体征变化及不良反应发生情况。结果 A组、B组术中收缩压、心率均高于术前，但B组均低于A组；B组术中脉搏血氧饱和度（SpO2）水平低于术前，且低于A组；差异均有统计学意义（均P<0.05）。C组术中收缩压、心率、SpO2水平与术前比较，差异均无统计学意义（均P>0.05），且术中收缩压、心率均低于A组、B组［（129±11）mmHg（1 mmHg=0.133 kPa）比（152±12）、（141±10）mmHg，（85±9）次/min比（106±15）、（93±12）次/min］，SpO2水平均高于A组、B组［（95.2±1.5）%比（92.1±1.0）%、（86.3±3.2）%］，差异均有统计学意义（均P<0.05）。C组不良反应总发生率低于A组、B组，差异有统计学意义（P＜0.01）。结论 在无痛电子支气管镜检查中，右美托咪定联合喉罩置入有利于患者麻醉中生命体征稳定，减少不良反应发生率，具有较高安全性。

• Objective To investigate the safety of dexmedetomidine(Dex) combined with laryngeal mask airway(LMA) placement in painless electronic bronchoscopy. Methods From January to August 2019, 96 patients undergoing electronic bronchoscopy of tumor biopsies in Zibo Municipal Hospital, Shandong Province were enrolled. According to drawing lots method, patients were divided into group A, B and C, with 32 cases in each group. Group A  was given topical anesthesia, group B was given propofol and fentanyl on the basis of group A, and group C was given Dex combined with LMA placement on the basis of group B. The changes of preoperative and intraoperative(3 min after bronchoscopy into the glottis) vital signs and adverse effects were compared among the three groups. Results The intraoperative systolic blood pressure(SBP) and heart rate in group A and group B were higher than those before operation, while those in group B were lower than those in group A; the intraoperative pulse oxygen saturation (SpO2) level in group B was lower than that before operation and lower than that in group A(all P<0.05). There were no significant differences in SBP, heart rate and SpO2 level before and during operation in group C(all P>0.05). During operation, SBP and heart rate in group C were lower than those in group A and group B［(129±11)mmHg vs (152±12), (141±10)mmHg; (85±9)times/min vs (106±15), (93±12)times/min］, and SpO2 level in group C was higher than that in group A and group B［(95.2±1.5)% vs (92.1±1.0)%,(86.3±3.2)%］(all P<0.05). The total incidence of adverse reactions in group C was lower than that in group A and group B(P＜0.01). Conclusion In painless electronic bronchoscopy, Dex combined with LMA placement is conducive to stabilize vital signs and it can reduce adverse reactions with high safety during anesthesia.