利多卡因雾化吸入复合丙泊酚在小儿纤维支气管镜检查中的应用研究

Application research of lidocaine aerosol inhalation combined with propofol in children with fiberoptic bronchoscopy

摘要:

目的 探讨利多卡因雾化吸入复合丙泊酚在小儿纤维支气管镜检查中的作用。方法 纳入80例行纤维支气管镜检查的小儿患者，采用随机数表法分为对照组和研究组。对照组予以丙泊酚静脉麻醉，研究组予以利多卡因雾化吸入复合丙泊酚静脉麻醉。对比两组患儿纤维支气管镜检查基础情况（包括检查时间、一次检查成功率和呛咳情况）和镇静满意率，记录纤维支气管镜检查前（T₁）、检查开始即刻（T₂）、检查开始后1 min（T₃）、检查开始后5 min（T₄）和检查结束即刻（T₅）的血流动力学指标［包括心率（HR）、平均动脉压（MAP）和经皮动脉血氧饱和度（SpO₂）］和不良反应发生率。结果 研究组检查时间短于对照组［（15.14±2.03）和（18.26±2.65）min］（P < 0.05），呛咳评分低于对照组［（2.13±0.33）和（2.86±0.47）分］（P < 0.05）；两组患儿一次检查成功率比较，差异无统计学意义（P > 0.05）；研究组镇静满意率为97.50%，明显高于对照组的80.00%，差异有统计学意义（P < 0.05）；两组患儿HR和MAP组间、时间和交互效应比较，差异均有统计学意义（P < 0.05）；两组患儿HR和MAP在T₂、T₃、T₄和T₅时点均高于T₁时点，且T₄、T₅时点均低于T₂、T₃时点，差异有统计学意义（P < 0.05）。研究组T₁、T₂、T₃、T₄和T₅时点HR慢于对照组，MAP低于对照组，差异有统计学意义（P < 0.05）；两组患儿SpO₂组间、时间和交互效应比较，差异均无统计学意义（P > 0.05）；两组患儿不良反应发生率比较，差异无统计学意义（P > 0.05）。结论 使用利多卡因雾化吸入复合丙泊酚，用于小儿纤维支气管镜检查，可以缩短检查时间，减轻呛咳程度，提高镇静满意率，维持血流动力学平稳，值得应用于临床。

Abstract:

Objective To investigate the effect of lidocaine aerosol inhalation combined with propofol in children with fiberoptic bronchoscopy.Methods 80 children with bronchofibroscopy were randomly divided into control group and study group. The control group was given propofol intravenous anesthesia, and the study group was given lidocaine nebulization inhalation combined with propofol intravenous anesthesia. Compare the basic conditions of children's fiberoptic bronchoscopy in the two groups (including time, success rate of one examination and cough), sedation satisfaction rate, hemodynamic indexes before fiberoptic bronchoscopy (T₁), immediately after examination (T₂), 1 min after examination (T₃), 5 min after the beginning of the examination (T₄) and immediately after the end of the examination (T₅) [including heart rate (HR), mean arterial pressure (MAP) and percutaneous arterial oxygen saturation (SpO₂)], and the incidence of adverse reactions.Results The examination time in the study group was shorter than that in the control group [(15.14 ± 2.03) and (18.26 ± 2.65) min] (P < 0.05), and the cough score was lower than that in the control group [(2.13 ± 0.33) and (2.86 ± 0.47)] (P < 0.05); There was no significant difference between the two groups in the success rate of the first examination (P > 0.05); The satisfaction rate of sedation in the study group was 97.50%, which was significantly higher than that in the control group (80.00%) (P < 0.05); There were significant differences in HR and MAP in terms of inter-group, time and interaction effects between the two groups (P < 0.05); HR and MAP were higher than T₁ at T₂, T₃, T₄ and T₅, and lower than T₂ and T₃ at T₄ and T₅ in the two groups (P < 0.05). HR at time points T₁, T₂, T₃, T₄ and T₅ in the study group was slower than that in the control group, and MAP was lower than that in the control group (P < 0.05); There was no significant difference in SpO₂ in terms of inter-group, time and interaction effects between the two groups (P > 0.05); There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05).Conclusion Lidocaine aerosol inhalation combined with propofol can shorten the examination time, reduce the degree of cough, improve the satisfaction rate of sedation, and maintain stable hemodynamics in children's fiberoptic bronchoscopy, which is worthy of clinical application.