全身麻醉面罩控制通气纤维支气管镜检查.docVIP

全身麻醉面罩控制通气纤维支气管镜检查 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：全身麻醉面罩控制通气纤维支气管镜检查 1 1 资料与方法 3 2 结果 4 22 HR的变化 T1~T5较T0值无显著变化，见表1。 4 3 讨论 4 文2：纤维支气管镜检查并发症的护理 6 1 临床资料 6 2 主要并发症及护理 6 3 讨论 8 参考文摘引言： 8 原创性声明（模板） 9 文章致谢（模板） 9 正文 全身麻醉面罩控制通气纤维支气管镜检查 文1：全身麻醉面罩控制通气纤维支气管镜检查 ［Abstract］ Objective To assess the feasibility and safety of noninvasive ventilation via a face mask to aid in performing fiberoptic bronchoscopy （FOB） undergoing general Twentysix adult patients，24~73 yea old，scheduled for elective cholecystectomy under general anaesthesia entered the was induced with midazolam mg/kg，propofol mg/kg，fentanyl 3 μg/kg and vecuronium mg/ blood pressure （BP），heart rate （HR） and oxygen saturation by pulse oximeter （SpO2）were recorded at the following time points: before anaesthesia（baseline T0）and immediately after anaesthesia induction（T1），when FOB at the level of pharynx（T2），vocal cords（T3），trachea （T4） and in 15 min of the FOB（T5）.Laryngospasm and cough were observed and the ratepressure product （RPP） at every time point was also Compared to T0，a significant decrease in BP and RPP（P＜001），while no significant change in HR was observed at BP，RPP and HR at T2~T5 did not exceed their baseline values at FOB the SpO2 was kept at or above baseline values，no laryngospasm，tracheospastm and cough were operation was welltolerated and no awareness The FOB with noninvasive ventilation via face mask undergoing general anaesthesia is comfortable and safe to the patients，the procedure can be completed successfully with BP，HR and SpO2 stabilization. ［Key words］ general anaesthesia；noninvasive ventilation；fiberoptic bronchoscopy；hemodynamics 纤维支气管镜（纤支镜）在呼吸系统疾病的诊断和 治疗 中具有重要作用，临床应用日趋广泛。然而，除儿童外，目前纤支镜的检查和治疗多采用局部麻醉或局部麻醉加用镇静剂的方法，这使患者在检查过程中常出现呛咳、气道痉挛或体动，不仅痛苦，而且可致缺氧、二氧化碳蓄积和血压、脉搏的剧烈波动［1，2］。因此，寻找一种安全、无痛苦、无体动条件下进行纤支镜检查的方法，就显得十分重要。本研究观察了全身麻醉经面罩通气纤支镜检查术，并对血流动力学指标、脉搏氧饱和度（SpO2）、术中知晓等情况做了观察，介绍如下。 1 资料与方法 11 一般资料 术前签署知情同意书，ASAⅠ～Ⅱ级，拟实施纤支镜检查的患者26例，男10例，女16例，年龄 24