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| 环泊酚与丙泊酚对肺结核患者无痛纤维支气管镜检查中呼吸抑制的影响 |
| Effects of ciprofol and propofol on respiratory depression in patients with pulmonary tuberculosis during painless fiberoptic bronchoscopy |
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| DOI：10.12089/jca.2026.01.009 |
| 中文关键词: 纤维支气管镜 环泊酚 丙泊酚 呼吸抑制 |
| 英文关键词: Fiberoptic bronchoscopy Ciprofol Propofol Respiratory depression |
| 基金项目:南京市卫生科技发展专项资金项目计划（YKK21125） |
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| 中文摘要: |
目的：比较环泊酚和丙泊酚对肺结核患者无痛纤维支气管镜检查中呼吸抑制的影响。
方法：选择行无痛纤维支气管镜检查的肺结核患者，年龄18～64岁，BMI 18.5～24.0 kg/m2，ASA Ⅱ或Ⅲ级。采用随机数字表法将患者分为两组：环泊酚组和丙泊酚组。环泊酚组麻醉诱导时静脉注射环泊酚0.5 mg/kg、瑞芬太尼0.2 μg/kg，检查中持续泵注环泊酚1 mg·kg-1·h-1；丙泊酚组麻醉诱导时静脉注射丙泊酚2 mg/kg、瑞芬太尼0.2 μg/kg，检查中持续泵注丙泊酚4 mg·kg-1·h-1。主要观察指标为检查中呼吸抑制发生情况。次要指标包括麻醉诱导前、麻醉诱导后、纤维支气管镜进声门后、检查结束时、出室时的HR、MAP、SpO2，低血压、心动过缓、心动过速的发生情况，实际禁食禁饮时间、检查时间、苏醒时间、瑞芬太尼消耗量、血管活性药物使用情况、麻醉中补液量、呛咳、体动、恶心呕吐、注射痛及满意度情况。
结果：共纳入患者62例，每组31例。与麻醉诱导前比较，麻醉诱导后两组HR明显减慢，MAP明显降低（P＜0.05）。与丙泊酚组比较，环泊酚组呼吸抑制、低血压发生率明显降低，麻醉诱导后和出室时SpO2、检查结束时MAP明显升高，麻黄碱用量和使用率明显降低，注射痛发生率明显降低，患者和内镜医师满意度明显升高（P＜0.05）。
结论： 与丙泊酚比较，环泊酚联合小剂量瑞芬太尼用于肺结核患者无痛纤维支气管镜的检查中可降低呼吸抑制、低血压的发生，满意度更高。 |
| 英文摘要: |
Objective: To compare the effects of ciprofol and propofol on respiratory depression during painless fiberoptic bronchoscopy in tuberculosis patients.
Methods: Patients with tuberculosis who undergoing painless fiberoptic bronchoscopy, aged 18-65 years, BMI 18.5-24.0 kg/m2, ASA physical status Ⅱ or Ⅲ were included. The random number table method was used to divide the patients into ciprofol group and propofol group. The ciprofol group was induced using ciprofol 0.5 mg/kg and remifentanil 0.2 μg/kg, ciprofol 1 mg·kg-1·h-1 to maintain anesthesia. The propofol group was induced using propofol 2 mg/kg and remifentanil 0.2 μg/kg, propofol 4 mg·kg-1·h-1 to maintain anesthesia. The primary outcome was the incidence of respiratory depression. Secondary outcomes included HR, MAP, and SpO2 before induction, post-induction, post-glottis insertion, end of procedure, and recovery, incidence of hypotension, bradycardia, and tachycardia, fasting duration, procedure and recovery times, remifentanil consumption, vasopressor use, fluid administration, incidence of cough, movement, nausea/vomiting, injection pain, and satisfaction.
Results: Sixty-two patients were included, 31 patients in each group. Compared with before induction, HR was significantly decreased and MAP was significantly reduced in both groups after post-induction (P < 0.05). Compared with the propofol group, the incidence of respiratory depression and hypotension was significantly reduced, the SpO2 levels after anesthesia induction and at the time of leaving the room, as well as the MAP at the end of the examination, were significantly higher in the ciprofol group, the dosage and usage rate of ephedrine have significantly decreased, the incidence of injection pain has also significantly reduced, and patient and endoscopist satisfaction was significantly increased (P < 0.05).
Conclusion: Compared to propofol, ciprofol combined with low-dose remifentanil reduces incidence of respiratory depression, hypotension, and injection pain while improving satisfaction in pulmonary tuberculosis patients undergoing painless fiberoptic bronchoscopy. |
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