CAJ | 학술논문

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.
목적 탐토일충유효방치쾌통도위장도수술후인부병발증적처리방법,이경호만족림상화환자적요구.방법 채용전첨성、수궤、쌍맹적연구방법,선택본원의재전마하행개복위장도수술자280례,수궤분위4조,각70례,A조(대조조),기관도관용의용석사유윤활;B조,기관도관용정잡인효장윤활;C조,기관도관용정잡인효장윤활+삽관후정주지새미송10 mg;D조,C조기출상가정주파서석포납40 mg.기록병비교각조마취발관후10 min、30 min、1 h、6 h、12 h、24 h시적술후인후통(POST)발생솔급엄중정도,관찰재PACU기간1 h내적흡담례수.결과 발관후10 min관찰점동기비교,B、C、D조POST발생솔저우A조(P<0.05);30 min관찰점동기비교,B、C、D조POST발생솔저우A조(P<0.05),D조분별저우B、C조(P<0.05);1 h관찰점동기비교,B、C、D조POST발생솔저우A조(P<0.05),D조분별저우B、C조(P<0.05);6 h관찰점동기비교,D조POST발생솔저우A조(P<0.05);12 h、24 h관찰점조간POST발생솔차이무통계학의의.재PACU관찰기간적흡담인수,C、D조발생솔저우A、B조(P<0.05);A、B조지간,C、D조간발생솔차이무통계학의의.결론 기관도관윤활복합정맥용약적다모식처리가유효방지POST,복합정주격소가유효감소발관후기도분비물.
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 gas-trointestinal 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 in-cidence of POST had no significant differences among groups. During PACU observation period, the inci-dence 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.