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中华普通外科学文献(电子版) ›› 2015, Vol. 09 ›› Issue (06) : 475 -478. doi: 10.3877/cma.j.issn.1674-0793.2015.06.014

所属专题: 文献

论著

快通道胃肠手术后咽部并发症处理方法的比较
李坤河1, 李毅1, 陈祯1, 黄贤君1, 肖亮灿1,()   
  1. 1. 510080 广州,中山大学附属第一医院麻醉科
  • 收稿日期:2015-07-20 出版日期:2015-12-01
  • 通信作者: 肖亮灿
  • 基金资助:
    广东省自然科学基金资助项目(S2012010010965)

Comparison of treatments for throat complications after fast-track gastrointestinal surgery

Kunhe Li1, Yi Li1, Zhen Chen1, Xianjun Huang1, Liangcan Xiao1,()   

  1. 1. Department of Anesthesiology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
  • Received:2015-07-20 Published:2015-12-01
  • Corresponding author: Liangcan Xiao
  • About author:
    Corresponding author: Xiao Liangcan, Email:
引用本文:

李坤河, 李毅, 陈祯, 黄贤君, 肖亮灿. 快通道胃肠手术后咽部并发症处理方法的比较[J/OL]. 中华普通外科学文献(电子版), 2015, 09(06): 475-478.

Kunhe Li, Yi Li, Zhen Chen, Xianjun Huang, Liangcan Xiao. Comparison of treatments for throat complications after fast-track gastrointestinal surgery[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2015, 09(06): 475-478.

目的

探讨一种有效防治快通道胃肠道手术后咽部并发症的处理方法,以更好满足临床和患者的要求。

方法

采用前瞻性、随机、双盲的研究方法,选择本院拟在全麻下行开腹胃肠道手术者280例,随机分为4组,各70例,A组(对照组),气管导管用医用石蜡油润滑;B组,气管导管用丁卡因胶浆润滑;C组,气管导管用丁卡因胶浆润滑+插管后静注地塞米松10 mg;D组,C组基础上加静注帕瑞昔布钠40 mg。记录并比较各组麻醉拔管后10 min、30 min、1 h、6 h、12 h、24 h时的术后咽喉痛(POST)发生率及严重程度,观察在PACU期间1 h内的吸痰例数。

结果

拔管后10 min观察点同期比较,B、C、D组POST发生率低于A组(P<0.05);30 min观察点同期比较,B、C、D组POST发生率低于A组(P<0.05),D组分别低于B、C组(P<0.05);1 h观察点同期比较,B、C、D组POST发生率低于A组(P<0.05),D组分别低于B、C组(P<0.05);6 h观察点同期比较,D组POST发生率低于A组(P<0.05);12 h、24 h观察点组间POST发生率差异无统计学意义。在PACU观察期间的吸痰人数,C、D组发生率低于A、B组(P<0.05);A、B组之间,C、D组间发生率差异无统计学意义。

结论

气管导管润滑复合静脉用药的多模式处理可有效防止POST,复合静注激素可有效减少拔管后气道分泌物。

Objective

To investigate the requirements for an effective processing strategy for post-operative sore throat (POST) to better meet the fast-track gastrointestinal surgery needs.

Methods

With prospective, randomized, double-blind study method, 280 patients under general anesthesia for gastrointestinal surgery were randomly divided into four groups. Group A: lubricated the head of tracheal tube with paraffin oil; Group B: lubricated the head of tracheal tube with tetracaine jelly; Group C: lubricated the head of tracheal tube with tetracaine jelly and 10 mg Dexamethasone i.v; Group D: lubricated the head of tracheal tube with tetracaine jelly and 10 mg Dexamethasone + 40 mg Dynastat i.v. A blinded observer interviewed all patients on postoperative sore throat and hoarseness at 10 min, 30 min,1 h, 6 h, 12 h, 24 h after extubation.

Results

In the 10 min observation point after extubation, the incidence of POST in group B, C, D was lower than group A (P<0.05). At the 30 min and 1 h observation points, the incidence of POST in group B、C, D was lower than group A (P<0.05); the incidence of POST in group D was lower than group C and B (P<0.05). In the 6 h observation point after extubation, the incidence of POST in group D was lower than group A (P<0.05); At the 12 h and 24 h observation points after extubation, the incidence of POST had no significant differences among groups. During PACU observation period, the incidence of suction in group C and D was lower than group A and B (P<0.05).

Conclusion

Multi-modal treatment of endotracheal tube lubricating composite intravenous drug can prevent POST, and intravenous injection of hormones can reduce airway secretions after extubation.

表1 患者一般资料的比较(各70例)
表2 拔管后各观察点POST发生率比较(70例)
1
Higgins PP, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery[J]. Br J Anaesth, 2002, 88(4): 582-584.
2
Scuderi PE. Postoperative sore throat: more answer than question[J]. Anesth Analg, 2010, 111(4): 831-832.
3
Knoll H, Ziegeler S, Schreiber JU, et al. Airway uties after one-lung ventilation: a comparison between double lumen tube and endobronehial blocker: a ramdomized, prospective, controlled trial[J]. Anesthesiology, 2006, 105(3): 471-477.
4
Menchke T, Echternach M, Kleinschmidt S, et al. Laryngeal morbidity and quality of tracheal intubation: a ramdomized controlled trial[J]. Anesthesiology, 2003, 98 (5): 1049-1056.
5
刘俊杰, 赵俊. 现代麻醉学[M]. 北京: 人民卫生出版社, 1987: 499.
6
Scuderi PE. Postoperative sore throat: more answers than questions[J]. Anesth Analg, 2010, 111(4): 831-832.
7
Hung NK, Wu CT, Chan SM, et al. Effect on postoperative sore throat of spraying the endotracheal tube cuff with benzydamine hydrochloride, 10% lidocaine, and 2% lidocaine[J]. Anesth Analg, 2010, 111(4): 882-886.
8
Tanaka Y, Nakayama T, Nishimori M, et al. Lidocaine for preventing postoperative sore throat[J]. Cochrane Database Syst Rev, 2015(7): CD004081.
9
Sumathi PA, Shenoy T, Ambareesha M, et al. Controlled comparison between betamethasone gel and lidocaine jelly applied over tracheal tube to reduce postoperative sore throat, cough, and hoarseness of voice[J]. Br J Anaesth, 2008, 100(2): 215-218.
10
侯立朝, 李树志, 熊利泽. 咽喉表面麻醉防治全麻术后咽喉痛[J]. 第四军医大学学报, 2002, 23(11): 1055-1056.
11
Flondor M, Listle H, Kemming GI, et al. Effect of inhaled and intravenous lidocaine on inflammatory reaction in endotoxaemic rats[J]. Eur J Anaesthesiol, 2010, 27(1): 53-60.
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