摘要
目的探讨喉上神经阻滞在门诊纤维支气管镜(纤支镜)检查术中的应用价值。方法随机将60例老年患者分成2组各30例,2组患者均先静脉注射咪达唑仑50μg/kg和芬太尼1μg/kg。Ⅰ组未做其他处理开始检查,Ⅱ组行双侧喉上神经阻滞,纤支镜过声门后,2组患者均经纤支镜侧孔注入2%利多卡因3mL行气管内局麻。记录纤支镜检查前(T_0),纤支镜进入咽喉即刻(T_1),纤支镜进入声门即刻(T_2),纤支镜进入气管内操作时(T_3)的平均动脉压、心率、脉搏血氧饱和度。记录整个检查治疗过程中患者的恶心、呛咳和躁动情况。结果所有患者均成功完成纤支镜检查。Ⅰ组T_1、T_2时间点平均动脉压和心率均较T_0增高和加快(P<0.05)且增高和加快比Ⅱ组明显(P<0.05)。与Ⅰ组比较,Ⅱ组呛咳、恶心、躁动发生率明显降低(P<0.05)。2组血氧饱和度均高于90%。结论喉上神经阻滞能够很好地抑制患者的咽喉部反射,降低心血管应激反应,对老年患者尤其有利,可以更好更快地完成门诊纤维支气管镜检查,是一种值得推荐的操作方法。
Objective To find the value of superior laryngeal nerve block in old patients bronehofibroscopy. Methods The two groups were injected midazolam 50p, g/kg and fentanyl 1 μg/kg at the beginning of the test. Then Group Ⅰ received bronchofibroscopy without any other treatment. While Group Ⅱreceived superior laryngeal nerve block before bronehofibroscopy examination. After bronchofibroscope entered the glottis,performed trachea local anesthesia by 3mL lidocaine from the lateral aperture of bronchofibroscope. The mean arterial pressure （ MAP）, heart rate （HR） and oxygen saturation of blood （ SpO2 ） were recorded at the time of before the test （ T0 ）, bronchofibroscope enter the throat （ T1）, bronchofibroscope enter the glottis （ T2 ）, procedure in trachea （ T3 ）. The patient＇s nausea, bucking and restlessness were observed. Results All procedure were completed successfully. In Group I , MAP and HR at the point of T1 and T2 were higher and faster than TO （ P 〈 0.05 ）. MAP and HR at the point of Tl and T2 were remarkably different between Group I and Group Ⅱ （ P 〈 0.05 ）. The occurrence of nausea, bucking and restlessness was lower in Group 11 （ P 〈 0.05 ）. The SpO2 of the two group was 〉 90%. Conclusion The superior laryngeal nerve block can inhibit the patient ＂s throat reflex, depress cardiovascular stress reaction, especially benefit for old patients. It is a recommendable procedure method.
出处
《河北医科大学学报》
CAS
2013年第1期37-39,共3页
Journal of Hebei Medical University
