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异丙托溴铵在纤维支气管镜检查中的应用研究

李磊1,张逊2,韩洪利2,徐医军2,韩兴鹏3,石珍亮3   

  1. 1. 天津医科大学研究生院
    2. 天津市胸科医院
    3. 天津市胸科医院胸外科
  • 收稿日期:2011-08-29 修回日期:2011-12-07 出版日期:2012-06-15 发布日期:2012-06-15
  • 通讯作者: 张逊

Application Study of Ipratropium in Fiberoptic Bronchoscopy

  • Received:2011-08-29 Revised:2011-12-07 Published:2012-06-15 Online:2012-06-15

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摘要： 摘要 目的：评价雾化吸入异丙托溴铵在纤维支气管镜检查中的应用价值。方法：选取拟进行纤维支气管镜检查的患者88例，分为实验组48例，于检查前雾化吸入异丙托溴铵1 mg，其中正常肺功能亚组24例，非正常肺功能亚组24例；对照组40例，其中正常肺功能亚组20例，非正常肺功能亚组20例，4组患者经利多卡因表面麻醉后进行支气管镜检查。比较4组患者检查前后气道阻力指标总气道阻力（R5）、中心气道阻力（R20）、周围弹性阻力（X5）及共振频率（Fres）的变化。结果：实验组在检查后R5、R20、X5及Fres均降低（P < 0.01）。2亚组间R5、R20、X5的改变量无明显差异。对照组中，正常肺功能亚组的气道阻力变化无统计学意义，非正常肺功能亚组在检查后R5、R20、X5、Fres均增加（均P < 0.01），且改变量均大于正常肺功能组。正常肺功能患者中，实验组R5、R20及Fres均有改善；X5也有改善，但差异无统计学意义。在非正常肺功能患者中，实验组R5、R20、X5及Fres有明显降低（均P < 0.05）。结论：纤维支气管镜检查前预防性应用异丙托溴铵可降低患者检查后的气道阻力，从而减小支气管痉挛发生率。

关键词: 支气管镜检查, 异丙托溴铵, 气道阻力, 共振频率, 呼吸功能试验, 支气管痉挛

Abstract: Abstract Objective：To study the application value of the inhalation of ipratropium in fiberoptic bronchoscopy. Methods: 88 patients undergoing bronchoscopy were enrolled in this study, 48 patients were divided into experimental group and inholed ipratropium 1 mg before bronchoscopy, including 24 patients in the normal lung function sub-group and 24 in the non-normal sub-group; control group of 40 patients, including 20 patients in the normal lung function sub-group and 20 in the non-normal sub-group. The patients of the four sub-groups undergoing bronchoscopy after lidocaine anesthesia. Compare the changes of the airway resistance index before and after the bronchoscopy, including the total airway resistance (R5), central airway resistance (R20), surrounding elastic resistance (X5) and the resonance frequency (Fres). Results: After bronchoscopy, R5, R20, X5 and Fres of the experimental group were reduced (P < 0.01). The changes of R5, R20, X5 between the two subgroups were not significant. In control group, the variations of airway resistance in the normal sub-group were not significant, R5, R20, X5, Fres were increased in the non-normal subgroups (P <0.01), and the change quantities were greater than normal sub-group. In the normal lung function group, R5, R20, Fres of the experimental group were more improvement, X5 was also improved, but the difference was not significant. In the non-normal lung function group, R5, R20, X5 and Fres of the experimental group were significantly reduced (P <0.05). Conclusion: Premedication with an inhaled ipratropium can reduce the airway resistance of patients undergoing bronchoscopy, which can reduce the incidence of bronchospasm.

Key words: bronchoscopy, ipratropium, airway resistance, Fres, respiratory function tests, bronchial spasm