Servicio de Neumología, Hospital Universitario 'Dr José E González', Universidad Autónoma de Nuevo León, Monterrey, Mexico.
Int J Tuberc Lung Dis. 2015 Mar;19(3):356-61. doi: 10.5588/ijtld.14.0632.
Diagnostic flexible bronchoscopy performed in hospitalised and ambulatory patients in a tertiary care academic hospital in Monterrey, Mexico.
To determine the effect of the route of insertion of the bronchoscope (oral or nasal) on patient comfort, vocal cord visualisation, local anaesthetic and sedation requirements and possible complications.
Prospective study carried out in patients aged ⩾ 18 years with an indication for flexible bronchoscopy. The route of insertion was randomly assigned. Symptoms related to the procedure were evaluated using a questionnaire.
Sixty-three patients were included: 32 in the oral insertion group and 31 in the nasal insertion group. There was no statistically significant difference in patient discomfort (1.91 ± 2.95 vs. 2.39 ± 3.56 points on a scale of 1 to 10, P = 0.74) or procedural complications (4 vs. 0 events, P = 0.12) between study groups. Oral insertion was associated with less time to vocal cord visualisation (25.5 ± 156 s vs. 56 ± 61 s, P < 0.01), lower requirement for lidocaine (15 ± 7.50 vs. 16 ± 4 ml, P = 0.01) and fewer insertion failures (0 vs. 6 cases, P < 0.01).
With intravenous sedoanalgesia, route of insertion did not affect patient comfort. However, the oral route was associated with faster vocal cord visualisation, less use of lidocaine and no insertion failure.
在墨西哥蒙特雷的一家三级保健学术医院中，对住院和门诊患者进行诊断性软性支气管镜检查。
确定支气管镜插入途径（经口或经鼻）对患者舒适度、声带可视化、局部麻醉和镇静需求以及可能发生的并发症的影响。
对年龄 ⩾ 18 岁且有软性支气管镜适应证的患者进行前瞻性研究。插入途径随机分配。使用问卷评估与操作相关的症状。
共纳入 63 例患者：32 例经口插入组，31 例经鼻插入组。两组患者的不适感（1 到 10 分制下的 1.91 ± 2.95 分与 2.39 ± 3.56 分，P = 0.74）或操作并发症（4 例与 0 例事件，P = 0.12）无统计学差异。与经鼻插入相比，经口插入更有助于更快地可视化声带（25.5 ± 156 s 与 56 ± 61 s，P < 0.01）、减少利多卡因的需求（15 ± 7.50 与 16 ± 4 ml，P = 0.01）以及降低插入失败率（0 例与 6 例，P < 0.01）。
在静脉镇静镇痛下，插入途径不影响患者舒适度。然而，经口途径与更快的声带可视化、更少的利多卡因使用以及无插入失败相关。
