妇科腹腔镜手术中气管导管套囊压力对患者术后咽喉痛的影响  

The changes of cuff pressure in the endotracheal tube during laparoscopic surgery and influence on postoperative sore throat

作　　者：胡静宜[1] 耿桂启[1] 李泓[1] 黄绍强[1] 

机构地区：[1]复旦大学附属妇产科医院麻醉科,上海市200090

出　　处：《中华护理杂志》2013年第3期222-223,共2页Chinese Journal of Nursing

摘　　要：目的探讨妇科腹腔镜手术气管导管套囊压力变化,以及对术后咽喉痛的影响。方法选择拟在气管插管全身麻醉下行腹腔镜手术或开腹手术的妇科患者各25例,进行全身麻醉诱导及气管插管后将套囊充气至25mmHg。分别于气管插管后5min、15min、30min、45min、60min记录套囊压力及气道峰压,于手术后2h及24h评估患者咽喉痛情况。结果腹腔镜手术患者套囊压力及气道峰压在各时间点均明显增加。开腹手术患者气管插管后各时间点气管导管套囊压力及气道峰压未见明显变化。患者气管导管套囊压力与气道峰压具有显著相关性,同开腹手术患者相比,腹腔镜手术患者术后2h及24h咽喉痛评分明显升高,差异有统计学意义(P<0.01)。结论气腹及头低脚高位会导致气道压及套囊压力升高,增加了患者术后咽喉疼痛的发生。Objective To investigate the changes of cuff pressure in the endotracheal tube during laparoscopie surgery and analyze the influence of cuff pressure on postoperative sore throat. Methods Fifty gynecologic patients receiving laparoscopic surgery（n=25） or open abdominal surgery（n=25） were recruited in this study. After anesthesia induction and tracheal intubation, the cuff pressure was set at 25 mmHg. The cuff pressure and airway pressure was recorded at 5 mins,15 mins,30 rains, 45mins and 60 mins after intubation. The patients＇ sore throat was measured at 2 hrs and 24 hrs after the surgery. Results The cuff pressure and airway pressure was stable during the surgery in patients receiving open abdominal surgery,while the cuff pressure and airway pressure was significantly increased during the surgery in patients receiving laparoscopic surgery. Moreover, there was positive correlation between the cuff pressure and airway pressure. The score of postoperative sore throat was significantly higher in the laparoscopic surgery group than in the open abdominal surgery group（P〈0.01 ）. Conclusion Pneumoperitoneum and the Trendelenburg position during laparoscopic surgery increase the airway pressure and cuff pressure, and may raise the incidence of postoperative sore throat.

关 键 词：插管法 气管内 压力 咽喉痛 套囊压力 

分 类 号：R473.71[医药卫生—护理学]