静脉全麻电子支气管镜检查及介入治疗的安全性

目的探讨静脉全麻电子支气管镜检查及介入治疗的安全性。方法实施电子支气管镜检查及介入治疗的患者共60例,随机分为改良喉罩通气静脉全麻下支气管镜检查组(研究组,30例),普通黏膜麻醉下支气管镜检查组(对照组,30例)。研究组在快速诱导全身麻醉下置入改良喉罩,连接麻醉机实施控制通气,置入电子支气管镜实施检查及介入治疗,对照组实施普通黏膜局麻。分别记录检查前(T0)、插入喉罩控制通气后(T1)、检查中(T2)、检查后(T3)不同时间点收缩压(SBP)、心率(HR)、氧分压(PaO2)及二氧化碳分压(PaCO2)的变化。结果研究组T2与研究组T1 SBP、HR、PaO2、PaCO2比较差异无统计学意义(P>0.05)。研究组T2与对照组T2 SBP、HR、PaCO2比较差异无统计学意义(P>0.05),研究组T2与对照组T2 PaO2比较差异有统计学意义(F=0.199,P=0.003)。研究组T3与对照组T3 SBP、HR、PaO2、PaCO2比较差异无统计学意义(P>0.05)。结论在静脉全麻下经改良喉罩实施控制通气行电子支气镜检查及介入治疗,研究组SBP、HR、PaCO2波动于正常范围,PaO2显著升高,有效避免了低氧血症的发生,具有临床应用价值。

Security of electronic bronchoscope examination and interventional therapy under intravenous anesthesia

Objective To discuss the security of electronic bronchoscope examination and interventional therapy under intravenous anesthesia.Methods A total of 60 patients implemented with electronic bronchoscope examination and interventional treatment were randomly divided into two groups,bronchoscopy inspection group with improved laryngeal mask airway under intravenous anesthesia(research group,including 30 cases) and bronchoscopy inspection group under common mucosal anesthesia(control group,including 30 cases).Not only the research group was placed the improved laryngeal mask and connected anesthesia apparatus to control ventilation,but also it was imbedded electronic bronchoscope to implement examination and interventional therapy in the rapid induction of general anesthesia.The control group was implemented common mucosal anesthesia.We respectively recorded changes of systolic blood pressure(SBP),heart rate(HR),oxygen partial pressure(PaO2) and carbon dioxide partial pressure(PaCO2) in different time points,such as before the examination(T0),after inserting the laryngeal mask to control ventilation(T1),on examination(T2),and after inspection(T3).Results The difference of SBP,HR,PaO2,PaCO2 between T2(research group) and T1(research group) was not statistically significant(P>0.05).The difference of SBP,HR,PaCO2 between T2(research group) and T2(control group) was not statistically significant(P>0.05),and the comparative differences of PaO2 between T2(research group) and T2(control group) had obviously statistical significance(F=0.199,P=0.003).The difference of SBP,HR,PaO2,PaCO2 between T3(research group) and T3(control group) was not statistically significant(P>0.05).Conclusion We could control ventilation by improved laryngeal mask and implementing electronic bronchoscope examination and interventional therapy under intravenous anesthesia.SBP,HR,PaCO2 of research group fluctuate in the normal range and PaO2 significantly increases,which effectively avoids the occurrence of hypoxemia and has clinical application value.