【摘要】 目的探讨鼻咽通气道在无痛支气管镜治疗中应用的有效性和安全性。方法方便选取2017年1月—2018年10月间行支气管镜下治疗的患者80例,将其随机分为观察组（Ⅰ组）和对照组（Ⅱ组）,每组40例。患者入室后经鼻导管吸氧（6～8 L/min）麻醉时静脉注射瑞芬太尼0.2～0.5μg/kg,丙泊酚3.5～4.0μg/mL靶控泵注;观察组至患者意识消失后置入I.D7.0 mm或者I.D7.5 mm鼻咽通气道,吸氧浓度（6～8 L/min）;对照组继续经鼻导管吸氧（6～8 L/min）。观察并分析两组患者麻醉前,检查开始时、术毕的MAP、HR及SpO₂以及苏醒时间和检查中的不良反应。并于术前（T0）、SpO₂降至最低时（T1）、术毕（T2）时抽取桡动脉血1 mL行血气分析。结果Ⅰ组术中T1时末梢血氧饱和度（SpO₂）（96.87±1.69）%明显高于Ⅰ组（90.85±3.44）%,不良反应发生率明显低于对照组,差异有统计学意义（t=11.256,P<0.05）。与T0时比较,T1时两组患者的PaCO₂均明显升高（P<0.05）;两组患者pH明显降低（P<0.05）;Ⅱ组术中T1时SpO₂（90.85±3.44）%较术前T0时（97.3±2.11）%明显降低（t=12.233,P<0.05）。结论相对于鼻导管给氧方法鼻咽通气道应用于无痛支气管镜治疗是安全的,同时不良反应率较低,但是有可能存在一定程度的呼吸抑制,应引起重视。更多还原

【Abstract】 Objective To investigate the efficacy and safety of nasopharyngeal airway in the treatment of painless bronchoscopy. Methods Convenient select eighty patients underwent bronchoscopy between January 2017 and October 2018 were randomly divided into observation group Ⅰ group and control group, Ⅱ group with 40 cases in each group. After the patient was admitted to the room, he was intravenously injected with remifentanil 0.2-0.5 ug/kg via anesthesia with oxygen inhalation, propofol 3.5-4.0 ug/ml target-controlled pump injection; observation group-to-patient consciousness disappeared after the placement of I.D7.0 mm or I.D7.5 mm nasopharyngeal airway, oxygen concentration（6-8 L/min）; the control group continued to inhale oxygen through the nasal cannula（6-8 L/min）. The MAP, HR, and SpO₂ at the beginning of the examination, the time of the operation, and the time of recovery and the adverse reactions during the examination were observed and analyzed before the anesthesia. At the time of preoperative（T0）, when SpO₂ was reduced to the lowest（T1）, and at the end of surgery（T2）, 1 mL of radial artery blood was taken for blood gas analysis. Results In the I group, the peripheral blood oxygen saturation（SpO₂）（96.87±1.69）% was significantly higher than that of the Ⅰ group（90.85±3.44）%, and the incidence of adverse reactions was significantly lower than that of the Ⅰ group. The difference was statistically significant（t=11.256, P<0.05）. Compared with T0, the PaCO₂ of the two groups was significantly increased at T1（P<0.05）; the pH of the two groups was significantly lower（P<0.05）; the SpO₂（90.85±3.44）% of T1 was compared with the Ⅱ group. At T0（97.3±2.11）% decreased significantly（t=12.233, P<0.05）. Conclusion Compared with nasal catheterization, the nasopharyngeal airway is safe for painless bronchoscopy, and the adverse reaction rate is low. However, there may be a certain degree of respiratory depression, which should be paid attention to.更多还原