无痛支气管镜与局麻支气管镜经支气管壁肺活检的对比

目的探讨无痛支气管镜与局麻支气管镜经支气管壁肺活检的效果及安全性。方法选择30例患者随机分为二组，A组为局麻组，用2％利多卡因行咽部、支气管局部麻醉。B组为无痛支气管镜组，予异丙酚（2±0．56）mg／kg，芬太尼50～100μg，术中滴注异丙酚维持麻醉，观察麻醉过程的各项指标、经支气管壁肺活检并发症、术后不良记忆、肺活检的难度，比较其特点。结果A组病人术中并发症、收缩压（SBP），舒张压（DBP）的改变、呼吸频率（RR）、心率（HR）、术中呛咳，体动发生率明显高于B组（P〈0．05）。B组病人脉搏氧饱和度（SpO2）较术前有所降低，但无统计学意义（P〉0．05），并发症降低，有统计学意义（P〈0．05）。结论无痛支气管镜较局麻支气管镜经支气管壁肺活检有较多的优点，极大地提高了麻醉质量，又节省了手术各方大量的时间，安全可靠，快捷方便，并发症少，效果满意。

A comparative analysis of painless and local anesthesia bronchoscopy in lung biopsy

Objective To explore the effects and safety of painless and local anesthesia bronchoscopy in lung biopsy. Methods 30 cases were divided into two groups randomly （ A and B group）. Group A consisted of 15 cases who were given 2% lidocaine on pharyngeal and bronchial for partial anesthesia. Group B consisted of 15 cases who were given （2 ± 0. 56） mg/kg propofol and 50 - 100μg fentanyl for general anesthesia. During the examination, measures were conducted, including indexes of the anaesthesia course, the complication of bronchoscopy in lung biopsy, postoperative harmful memory and the difficulty of lung biopsy, and their characteristics. Results The complication, change of the SBP, DBP, RR and HR, phenomena of choking and coughing, body maneuver appeared much more in Group B than in Group A （ P 〈 0. 05 ）. The SpO2 of Group A decreased slightly, which had little difference before the procedure （ P 〉0. 05 ）. But the complication decreased significantly, which had statistical significance （P 〈 0.05 ）. Conclusion Compared with partial anesthesia bronchoscopy, painless bronchoscopy has much more advantages. It enhances anesthesia quality significantly, save the time of all sides of operation. It is safer and more reliable. Thus it deserves to be vromoted for a wider use in clinical nractice.