目的 探讨支气管镜检查过程中的自主神经系统的相互作用.方法 100例患者根据术前准备方法不同随机分为两组:A组:2％利多卡因吸入麻醉的同时于术前30 min肌肉注射阿托品1 mg;B组:2％利多卡因吸入麻醉.分别记录术前(T1)、通过咽部(T2)、通过声门(T3)、气管内注入2％利多卡因后(T4)、操作过程中(T5)、结束时(T6)的心率(HR)、血氧饱和度(SPO2),并记录T1和T6的血压(BP)等数据.结果 组内与术前对比:两组HR均从T3开始增快,差异具有显著性；SPO2:A组各时间点差异无显著性,B组从T3开始下降,差异具有显著性；BP:A组收缩压(SBP)差异无显著性；B组SBP升高,差异具有显著性.组间比较:HR在T1、T2、T3和T6时A＞B,差异具有显著性,但在T4和T5时两组问差异无显著性.结论 阿托品在支气管镜检查过程中能使患者保持更稳定的HR、SPO2及SBP.对支气管镜检查过程中自主神经系统的协调稳定起到一定的作用.%[Objective] To discuss the interaction of autonomic nerve system (during the bronchoscopy. [Methods] 100 patients were divided into two groups at random: experiment group (group A) in which atropine was used before inhalational anaesthesia and control group (group B) with inhalational anaesthesia only. The heart rate (HR) and oxygen saturation of blood (SPOj) were observed at time points as follows: before the bronchoscopy (Tl), crossing the pharynx (T2) and the glottis (T3), injecting lidocaine in the trachea (T4), during the bronchoscopy (T5) and after the bronchoscopy (T6). Meanwhile the blood pressure (BP) was observed before and after the bronchoscopy. [ Results] The HR of both groups, beginning to increase at T3, had a significant difference compared with that at Tl (P <0.05). And the values in group A were higher than those in group B at Tl236 (P <0.05). There had no obvious significance between two group at T4 and T5 (P >0.05). The SPO2 data had no significant difference between T2-6 and Tl in group A (P >0.05). Otherwise they began to decrease from T3 in group B (P <0.05). The systole blood pressure (SBP) difference weren't obvious significant between Tl and T6 in group A (P >0.05). Yet they were higher at T6 in group B (P <0.05). [Conclusion] The HR, SPO2 and SBP under the bronchoscopy are more stable if using atropine before inhalational anaesthesia, and there is something in the coordination of autonomic nerve system and atropine under the bronchoscopy.
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