盐酸右美托咪定在支气管镜检查中的应用

摘要

目的 评价盐酸右美托咪定在支气管镜检查中应用的有效性和安全性.方法 在我院住院行支气管镜检查的患者100例,将其随机分为无痛组和普通组,各50例,普通组仅常规使用利多卡因咽喉部局部麻醉加肌内注射地西泮,无痛组在上述咽喉部局部麻醉基础上术前缓慢静脉注射右美托咪啶0.5 μg/kg,随后以0.1～0.5 μg/(kg·h)速率维持.比较2组患者在检查前、中、后的平均动脉压(MAP)、HR、脉搏血氧饱和度(SpO2)、呼吸频率的变化和检查中的不适反应及检查后对支气管镜检查的满意度.结果 无痛组检查中MAP、HR分别为(88±5)mm Hg、(76±15)次/min,普通组分别为(92±4) mm Hg、( 80±2)次/min,2组比较差异有统计学意义(P＜0.05).无痛组患者的满意度为98％ (49/50),普通组患者的满意度为40％(20/50),2组比较差异有统计学意义(P＜0.01).结论 应用盐酸美托咪定进行电子支气管镜检查,是一种安全、有效、舒适性好、无明显呼吸抑制的方法,值得临床推广应用.%Objective To evaluate the efficacy and safety of dexmedetomidine hydrochloride in the sedation of bronchoscopy examination.Methods The patients with bronchoscopy examination were divided into two groups:pain-free group and the general group. The patients in the general group received throat local anesthesia with lidocaine and intramuscular injection with diazepam. The pain-free group received intravenous injection with dexmedetomidine hydrochloride 0.5 μg/kg on the basis of throat local anesthesia. The mean arterial pressure (MAP),heart rate (HR),oxygen saturation (SpO2 ),respiratory rate (RR)were observed before,during and after the bronchoscopy examination. The degree of discomfort was compared during the examination and the satisfaction degree was also compared after the examaination.Results The MAP,HR of pain-free group was (88±5)mm Hg,(76±15)min during the examination,while the MAP,HR of general group was (92±4)mm Hg,(80±2)min (P＜0.05 ).The satisfaction of pain-free group was 98％ (49/50)and the satisfaction of general group was 40％ (20/50)(P ＜0.01 ).The pain-free group showed lower discomfort degree and higher satisfaction degree than general group.Conclusion The use of dexmedetomidine hydrochloride in bronchoscopy examination is a safe,effective and comfortable without significant respiratory depression method.