杨磊　汪伟　郁万友　钱燕宁

【[摘要] 目的 探讨全麻复合羟考酮与芬太尼用于门诊纤支镜检查中的镇痛效果及安全性。方法 随机选取2016年1月—2017年12月该院100例门诊纤支镜检查患者为研究对象，依据镇痛方法不同分为实验组（全麻复合羟考酮，50例）和对照组（全麻复合芬太尼，50例），对比观察两组镇痛效果，统计不良反应。结果 实验组术中镇痛优良率96.0%，术后镇痛优良率90.0%，均优于对照组，差异有统计学意义（χ2=5.42，P<0.05；χ2=4.63，P<0.05，）；实验组不良反应发生率（4. 0%）低于对照组（12.0%），差异有统计学意义（χ2=3.16，P<0.05）。结论 门诊纤支镜检查采用全麻复合羟考酮术中、术后镇痛效果确切，不良反应少，安全性高，可提高患者舒适度，保证检查顺利完成，值得推广使用。

[关键词] 羟考酮；芬太尼；镇痛；效果；安全性

[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742（2018）04（c）-0120-03

Analysis of Analgesic Effect of Outpatient Bronchofiberscope Examination General Anesthesia Combined with Oxycodone and Fentanyl

YANG Lei1， WANG Wei1， YU Wan-you1， QIAN Yan-ning2

1.Department of Anesthesia， Jiangning Hospital Affiliated to Nanjing Medical College， Nanjing， Jiangsu Province， 211100 China；2.Department of Anesthesia， Jiangsu Provincial Peoples Hospital， Nanjing， Jiangsu Province， 210029 China

[Abstract] Objective To study the analgesic effect and safety of outpatient bronchofiberscope examination general anesthesia combined with oxycodone and fentanyl. Methods 100 cases of patients with outpatient bronchofiberscope examination admitted and treated in our hospital from January 2016 to December 2017 were random selected as the research objects and divided into two groups with 50 cases in each according to the analgesic effect， the experimental group used the general anesthesia combined with oxycodone， while the control group used the general anesthesia combined with fentanyl， and the analgesic effect was compared between the two groups， and the adverse reactions were counted. Results The intraoperative analgesic excellent and good rate and postoperative analgesic excellent and good rate in the experimental group were respectively 96.0% and 90.0%， which were better than those in the control group， and the differences were statistically significant（χ2=5.42， P<0.05；χ2=4.63， P<0.05）， and the incidence rate of adverse reactions in the experimental group was lower than that in the control group， （4. 0% vs 12.0%）， and the difference was statistically significant（χ2=3.16， P<0.05）. Conclusion The effect of outpatient bronchofiberscope examination general anesthesia combined with oxycodone and fentanyl is definite， with few adverse reactions and high safety， which can improve the comfort degree of patients and ensure the successful examination， and it is worth promotion and application.

[Key words]Oxycodone； Fentanyl； Analgesic； Effect； Safety

纖支镜即纤维支气管镜，是以丙烯树脂或玻璃材质的超细纤维组成导光束，经口鼻咽喉部插入气管、支气管或肺部以直接进行病变观察和疾病诊断的内窥镜检查技术[1]，可在表面无创的情况下发现及诊断呼吸系统深部病变，临床应用广泛。但是，纤支镜检查属侵入性操作，可产生明显不良刺激，造成患者强烈不适，对此，临床多以麻醉及镇静、镇痛药物辅助检查，以维持患者浅睡眠状态，从而减少不适，提高耐受及依从性，保证检查顺利完成[2]。文章现以2016年1月—2017年12月该院100例门诊纤支镜检查患者为例，对全麻复合羟考酮与舒芬太尼的镇痛效果进行分析和探讨，现报道如下。

1 资料与方法

1.1 一般资料

随机选取该院100例门诊纤支镜检查患者为研究对象，依据镇痛方法不同分为两组。实验组（50例）：男32例，女18例；年龄25～54岁，平均（41.7±8.3）岁；BMI 18.3～25.4 kg/m2，平均（22.4±1.6）；检查操作时间15～45 min，平均（27.2±9.6）min。疾病类型：咯血或痰中带血14例，肺部肿块13例，顽固性咳嗽9例，肺不张8例，不明原因喘鸣6例。……