1.九江学院附属医院，呼吸内科，江西 九江 332000;2.九江学院附属医院，麻醉科，江西 九江 332000
1.Department of Respiratory Medicine, the Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi 332000, China;2.Department of Anesthesiology, the Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi 332000, China
目的 探讨不同剂量芬太尼联合咪达唑仑在支气管镜检查中的舒适性和安全性。方法 选取入住该院呼吸内科且需要行电子支气管镜检查的住院患者共136例，分为试验组101例和对照组35例，试验组分为3个亚组，即：单用咪达唑仑组（A组）、25 μg芬太尼联合咪达唑仑组（B组）、50 μg芬太尼联合咪达唑仑组（C组）。记录4组患者行支气管镜检查前和检查中的镇静评分、咳嗽程度、心率（HR）、收缩压（SBP）、舒张压（DBP）和脉搏血氧饱和度（SpO2）的变化。结果 A组与对照组镇静评分、HR、SBP、DBP和SpO2比较，差异均有统计学意义（P < 0.05），但两组咳嗽程度无明显差异（P > 0.05）；B组、C组与对照组上述指标比较，差异均有统计学意义（P < 0.05）；同时B组与A组、C组与A组两两比较，在HR、SBP、DBP和SpO2方面，差异均有统计学意义（P < 0.05）。C组与A组咳嗽症状比较，差异有统计学意义（P < 0.05）；C组HR、SBP、DBP与B组比较，差异均有统计学意义（P < 0.05）。结论 给予支气管镜检查患者使用芬太尼联合咪达唑仑，舒适性和安全性明显优于单用咪达唑仑，且未增加副作用，与25 μg芬太尼联合咪达唑仑比较，50 μg芬太尼联合咪达唑仑效果更佳。
Objective To explore the comfort and safety of different doses of Fentanyl combined with Midazolam in bronchoscopy.Methods 136 inpatients required electronic bronchoscopy were divided into test group (101 cases) and control group (35 cases). The test group was divided into three subgroups, namely Midazolam alone Group (A group), 25 μg Fentanyl combined with Midazolam group (B group), 50 μg Fentanyl combined with Midazolam group (C group). The sedation scores, cough degree, heart rate, systolic and diastolic blood pressure, and changes in finger pulse oxygen values of the four groups of patients before and during the bronchoscopy were recorded.Results Compared with the control group, group A patients had significant differences in sedation score, heart rate, blood pressure, finger pulse oxygen (P < 0.05), but there was no significant difference in the degree of cough between the two groups (P > 0.05); Group B and Group C were significant differences in the above indicators between the two groups of patients and the control group (P < 0.05); At the same time, group B compared with group A, group C compared group A in terms of HR, SBP, DBP and SpO2, the difference was statistically significant (P < 0.05). There was a statistically significant difference in cough symptoms between group C and group A (P < 0.05); Group C and group B were also statistically difference in heart rate, systolic blood pressure and diastolic blood pressure (P < 0.05).Conclusion The comfort and safety of using Fentanyl combined with Midazolam for patients underwent bronchoscopy were significantly better than that of Midazolam alone, and it did not add additional side-effects；especially, 50 μg Fentanyl combined with Midazolam were better than 25 μg Fentanyl.