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目的：探讨咪达唑仑静脉推注联合利多卡因局部麻醉在老年患者支气管镜检查中的应用效果。方法：选取2012 年10 月 -2015 年10 月我院收治的符合支气管镜检查适应症的240 例老年患者，并将其随机分为对照组和实验组，每组120 例。对照组患者术前仅采用2%利多卡因进行雾化吸入局部麻醉，实验组患者术前在对照组基础上静脉推注2 mg 咪达唑仑。检测两组患者麻醉后支气管镜检查前（T1）、支气管镜检查后5 min（T2）的生命体征指标，比较支气管镜检查前后不良反应发生情况及检查后满意度。结果：实验组患者T1 时呼吸频率（RR）、心率（HR）、收缩压（SBP）与T2 时HR 和SBP 均明显低于对照组（P<0.05）；对照组 HR、SBP 检查前后有明显波动（P<0.05），而实验组检查前后各生命体征指标差异无统计学意义（P>0.05）。实验组患者不良反应发生率为69.17%，明显低于对照组的81.67%（P<0.05）。实验组患者术后满意度为96.67%，明显高于对照组的85.83%（P<0.05）。结论：咪达唑仑静脉推注联合利多卡因局部麻醉相比于单独应用利多卡因具有较好的安全性和耐受性，满意度高而不良反应少，适用于临床上老年患者支气管镜检查。

英文摘要:

Objective:To explore the effect of midazolamintravenous infusion combined with lidocaine local anesthesia in elderly bronchoscopyMethods:A total of 240 elderly patients who consisted with bronchoscopy indications in our hospital from October 2012 to October 2015 were selected, randomly divided into control group(n=120) and experiment group(n=120). The control group were only treated with 2% lidocaine local anesthesia by atomizing inhalation before bronchoscopy, while the experiment group were added 2 mg midazolam intravenous infusion base on the control group therapy before bronchoscopy. The vital sighs indicators after anesthesia and before bronchoscopy (T1) and 5 min after bronchoscopy (T2) were detected, the adverse reactions before and after bronchoscopy, as well as satisfaction degree after bronchoscopy were observed.Results:Respiratory rate(RR), heart rate(HR), systolic blood pressure (SBP) of experiment group at T1, and HR and SBP at T2 were significantly lower than the control group (P<0.05); The levels of HR and SBP in control group before and after bronchoscopy were significantly changed (P<0.05), while the vital sighs indicators in experiment group had no significantly change (P>0.05). The incidence rate of adverse reaction rate in experiment group was 69.17%, which was significantly lower than 81.67% in control group (P<0.05). The satisfaction degree in experiment group was 96.67%, which was significantly higher than 85.83%in control group(P<0.05).Conclusion:Compared with lidocaine local anesthesia, midazolam intravenous infusion combined with lidocaine local anesthesia not only has higher safety and tolerance degree, but also with better satisfaction degree and lower adverse reactions, which is more suitable to be applied in the clinical elderly bronchoscopy.

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