丙泊酚在婴幼儿纤维支气管镜检查中的应用

摘要

Objective To explore the feasibility and safety of propofol during transvenous anaesthesia in flexible bronchoscopy in infants.Methods Fifty infants (3 months to 3 years old) undergoing fiberbronchoscopy with propofol during transvenous anesthesiafrom May 2012 to December 2013 were enrolled.The dosage,acting time,waking up time,vital signs during operation[heart rate (HR),diastolic blood pressure (DBP),O2 saturation(SpO2)] and side effects (respiratory depression,cough,laryngeal edema,etc.) were recorded.The clinical biochemistry biomarkers (liver function,blood lipids,lactate) immediately after operation and 1 day after-operation were also observed.Results There were no significant changes regarding vitalsigns before check,after induction,over the glottis andtracheal carina,after inspection [heart rate:(139 ± 14),(131 ± 14),(140 ± 17),(142±16),(133±15)times/min;diastolic blood pressure:(61±9),(57 ±9),(59±10),(62±12),(62±13) mmHg;SpO2:(99.1 ±1.1)％,(99.2±1.0)％,(98.5 ±1.2) ％,(95.9 ±7.6)％,(99.2± 1.1) ％] (P ＞ 0.05).The waking up time after operation was short and no severe complications were observed.The liver function,blood lipids and lactate did not show significant changes after operation (P ＞ 0.05).No propofol infusion syndrome was observed.Conclusion Propofol is safe and effective duringtransvenous anaesthesia in fiberbronchoscopyin infants.%目的 评价丙泊酚静脉麻醉应用于婴幼儿纤维支气管镜检查的安全性及可行性.方法 选取2012年5月至2013年12月行纤维支气管镜检查的患儿50例,年龄1个月～3岁,应用丙泊酚镇静、麻醉.记录患儿用药剂量、起效及苏醒时间、术中生命体征(心率、血压、脉搏血氧饱和度)和不良反应(呼吸抑制、呛咳、喉头水肿等),同时记录操作结束后即刻、术后第1天的生化指标(肝功能、血脂、乳酸).分析并比较上述指标在纤维支气管镜术前术后的变化.结果 50例患儿检查前、诱导后、过声门、达隆突、检查后心率分别为(139±14)、(131 ±14)、(140±17)、(142±16)、(133±15)次/min;舒张压分别为(61±9)、(57±9)、(59±10)、(62±12)、(62±13) mmHg(1 mmHg =0.133 kPa);脉搏血氧饱和度(SpO2)分别为(99.1±1.1)％、(99.2±1.0)％、(98.5±1.2)％、(95.9±7.6)％、(99.2±1.1)％,术中心率、血压、SpO2与检查前基础值比较,差异无统计学意义(P＞0.05);术后苏醒时间短,未出现严重不良反应;患儿检查前后肝功能、血脂水平、乳酸等生化指标差异均无统计学意义(P＞0.05),未出现丙泊酚输注综合征.结论 丙泊酚静脉麻醉用于婴幼儿纤维支气管镜检查较为安全,效果良好.