目的 探讨无创通气支持下无痛电子支气管镜检查在临床应用中的可行性及优缺点.方法 对施行无创通气支持下无痛电子支气管镜检查和同期行常规电子支气管镜检查患者各258例进行分析.结果 无创通气支持下无痛支气管镜检查成功率100%,明显优于常规组(100%对89.4%);术前-术中心率、呼吸频率、血压明显波动发生率高于无痛组,无痛组大多数患者对手术操作无不良记忆,常规组患者大多数有不同程度的不耐受,术中血压升高、呛咳、呼吸困难、术后不良记忆明显高于无痛组.结论 无创通气支持下无痛电子支气管镜检查明显提高检查成功率,同时改善患者检查时感受、安全、提高诊断率.无痛支气管镜检查在对大于70岁患者,有少数出现低血压、嗜睡及谵妄副作用,需要引起重视.%Objective To evaluate the usefulness and safety of painless bronchoscopy via laryngeal mask air-way with noninvasive positive pressure ventilation. Methods The clinical data of 258 patients detected by painless bronchoscopy via laryngeal mask airway with noninvasive positive pressure ventilation had been analyzed, and com-pared with the data of 258 patients detected by route bronchoscopy. Results The achievement rate of detection in the painless bronchoscopy group was higher than that in the route bronchoscopy group (100% via 89. 4%). The vari-ance ratio of heart rate, respiratory frequency and blood pressure between preoperative and postoperative in the pain-less bronchoscopy group was lower than that in the route bronchoscopy group. The intolerance of detection, adverse reaction of intraoperative ( including elevated blood pressure, bucking and dyspnea) and indisposition memory post-operative in the route bronchoscopy group emerged more than that in the painless bronchoscopy group. Conclusion There is better experience personally and more achievement ratio of detection in the painless bronchoscopy group. It should pay close attention that the detection to the old age patients may appear partly with low blood pressure and hy-persomnia or delirium in the painless bronchoscopy group.
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