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南京市第二医院麻醉科,江苏 南京210003
王佳,E-mail:janic@163.com
收稿日期:2024-05-08,
纸质出版日期:2025-06-25
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陈雨辰,王佳,杨晓宇.右美托咪定在肺结核纤维支气管镜检查中的应用效果[J].局解手术学杂志,2025,34(06):548-551.
CHEN Yu-chen,WANG Jia,YANG Xiao-yu.Application effect of dexmedetomidine in fiberoptic bronchoscopy for pulmonary tuberculosis[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(06):548-551.
陈雨辰,王佳,杨晓宇.右美托咪定在肺结核纤维支气管镜检查中的应用效果[J].局解手术学杂志,2025,34(06):548-551. DOI: 10.11659/jjssx.05E024018.
CHEN Yu-chen,WANG Jia,YANG Xiao-yu.Application effect of dexmedetomidine in fiberoptic bronchoscopy for pulmonary tuberculosis[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(06):548-551. DOI: 10.11659/jjssx.05E024018.
目的
2
探讨右美托咪定用于肺结核患者纤维支气管镜(纤支镜)检查中的效果。
方法
2
选择2021年5月至2023年5月于我院行纤支镜检查的100例肺结核患者,使用分层抽样方法,选择使用右美托咪定及未使用右美托咪定干预的患者各50例,分别设为观察组与对照组。对照组患者采用常规静脉全身麻醉;观察组患者采用右美托咪定+静脉全身麻醉。比较2组患者手术及麻醉指标、血流动力学指标、炎症反应、应激反应及不良反应情况。
结果
2
观察组患者麻醉起效时间短于对照组,丙泊酚追加次数、丙泊酚消耗量少于对照组,苏醒时间长于对照组,差异均有统计学意义(
P
<
0.05)。2组患者进镜检查即刻平均动脉压(MAP)、心率(HR)均较术前上升(
P
<
0.05),血氧饱和度(SpO
2
)较术前降低(
P
<
0.05);观察组患者进镜检查即刻MAP、HR低于对照组,SpO
2
高于对照组,差异均有统计学意义(
P
<
0.05)。术后2组患者NOD样受体热蛋白结构域相关蛋白3(NLRP3)、白细胞介素-1β(IL-1β)、白细胞介素-8(IL-8)、丙二醛(MDA)、皮质醇(Cor)、促肾上腺皮质激素(ACTH)水平均较术前上升(
P
<
0.05),但观察组上述指标均低于对照组,差异有统计学意义(
P
<
0.05)。2组患者不良反应发生率比较,差异无统计学意义(
P
>
0.05)。
结论
2
右美托咪定在肺结核患者纤支镜检查中麻醉效果较好,能够稳定血流动力学,抑制炎症及应激反应,安全性较高。
Objective
2
To investigate the effect of dexmedetomidine on fiberoptic bronchoscopy in patients with pulmonary tuberculosis.
Methods
2
A total of 100 patients with pulmonary tuberculosis who underwent fiberoptic bronchoscopy in our hospital from May 2021 to May 2023 were selected.Using stratified sampling method,50 patients with dexmedetomidine intervention and 50 patients without dexmedetomidine intervention were selected as the observation group and the control group, respectively.Patients in the control group were given routine intravenous general anesthesia,while patients in the observation group were given dexmedetomidine + intravenous general anesthesia.The surgical and anesthesia indexes, hemodynamic indexes, inflammatory response, stress response and adverse reactions were compared between the two groups.
Results
2
The onset time of anesthesia in the observation group was shorter than that in the control group, the additional times of propofol and the consumption of propofol were less than thos
e in the control group, and the recovery time was longer than that in the control group, and the differences were statistically significant (
P
<
0.05).The mean arterial pressure (MAP) and heart rate (HR) of the two groups immediately upon fiberoptic bronchoscopy were higher than those before surgery (
P
<
0.05), and the peripheral capillary oxygen saturation (SpO
2
) was lower than that before surgery (
P
<
0.05).The MAP and HR immediately upon fiberoptic bronchoscopy of the observation group were lower than those of the control group, and the SpO
2
was higher than that of the control group, and the differences were statistically significant (
P
<
0.05).The levels of NOD-like receptor pyrin domain containing 3 (NLRP3), interleukin-1β (IL-1β), interleukin-8(IL-8), malondialdehyde (MDA), cortisol (Cor) and adrenocorticotropic hormone (ACTH) in the two groups after surgery were higher than those before surgery (
P
<
0.05), but the above indexes in the observation group were lower than those in the control group,and the differences were statistically significant (
P
<
0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups (
P
>
0.05).
Conclusion
2
Dexmedetomidine has a good anesthetic effect in patients with pulmonary tuberculosis undergoing fiberoptic bronchoscopy, which can stabilize hemodynamics, inhibit inflammation and stress response, and has high safety.
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