异丙酚与异丙酚联合芬太尼用于老年患者无痛纤支镜的临床研究

目的研究异丙酚、异丙酚联合芬太尼用于老年患者无痛纤支镜的效果及安全性。方法60例纤支镜检查老年患者,分为三组。A组静脉推注异丙酚;B组静脉滴注芬太尼后静脉推注异丙酚;C组常规纤支镜检查。监测检查前、插镜时、检查结束时收缩压（SBP）、舒张压（DBP）、心率（HR）、血氧饱和度（SpO2）,记录异丙酚用量、意识消失时间、意识恢复时间及不良反应及术后感受。结果A、B两组异丙酚用量、意识消失时间、意识恢复时间无明显差异。A、B组插镜时SBP、DBP及HR出现一过性下降,SpO2明显下降（P〈0.01）,但在90%以上。C组插镜时SBP、DBP及HR明显升高。A、B组不良反应低于C组,术后感受及满意度优于C组。结论异丙酚与异丙酚联合芬太尼均能安全应用于老年患者纤支镜检查。

Clinical study Propofol and Propofol-Fentanyl in Painless Fiberoptic Bronchoscopy of Elderly Patients

Objective To evaluate the analgesic efficiency and security of propofol and propofol-fentanyl in painless fiberoptic bronchoscopy of elderly patients.Methods 60 ASAI-II elderly patients scheduled for fiberoptic bronchoscopy（aged between 60～80）were randomly divided into three groups：simple propofol group（group A,n=20）,who was intravenously injected propofol（1.5～2.0 mg/kg）;propofol-fentanyl group（group B,n=20）,in which patients were given 1 μg/kg of fentanyl intravenously before propofol（1.0～1.5 mg/kg）was injected intravenously and ordinary fiberoptic bronchoscopy group（group C,n=20,as control）.The SBP,DBP,HR,SpO2 were recorded.The total drug consumption,the recovery time and the side effects were also noted.Questionnaires for patients were performed after fiberoptic bronchoscopy.Results There were no significant change for the total drug consumption and the recovery time between group A and group B.The SBP,DBP and HR decreased and the SpO2 decreased significantly（P〈0.01）after anaesthesia in group A and B,however,they recovered to baseline immediately after fiberoptic bronchoscopy.The SBP,DBP,HR increased significantly in group C（P〈0.05）.Much less discomfort of patients were observed in group A and B than in group C（P〈0.01or P〈0.05）.The subject assess of group A and group B were significantly better than that of group C.Conclusion Using propofol or propofol-fentanyl can make fiberoptic bronchoscopy more comfortable,more effective and safer in elderly patients.