预防应用布地奈德雾化吸入对全身麻醉甲状腺良性肿物切除术后患者咽喉部并发症的临床疗效观察  

The clinical curative effect observation of preventive application of budesonide aerosol inhalation to throat complications of thyroid benign neoplasm resection patients after general anesthesia

作　　者：韩雅婧 赵瑛[1] 

机构地区：[1]山西医科大学第一医院,030001

出　　处：《实用医技杂志》2014年第7期707-710,共4页Journal of Practical Medical Techniques

摘　　要：目的观察全身麻醉甲状腺术后患者在预防雾化吸入布地奈德后咽喉部症状的改善情况。评价不同方式雾化吸入对患者气管插管后咽喉部症状和体征的疗效。方法将120例采用全身麻醉行气管插管的甲状腺良性肿物切除手术患者,随机分为4组,每组30例:A组(予以布地奈德1 mg术前1 h,布地奈德1 mg术后8、24、48 h雾化吸入)、B组(予以布地奈德1 mg术后8、24、48 h雾化吸入)、C组(术后同时段予以地塞米松5 mg+0.9%氯化钠注射液10 mL雾化吸入)和D组(术后同时段予以0.9%氯化钠注射液10 mL雾化吸入)。患者坐位或半卧位,均采用氧气作为雾化吸入的驱动力,喷雾器和地面垂直,雾化时间均为5 min。观察各组患者术后咽喉部情况,评价不同方式雾化吸入对患者气管插管后咽喉部症状和体征的疗效。结果各组患者年龄、吸烟史和气管插管带管时间比较,差异均无统计学意义(P>0.05)。咽痛视觉模拟评分法(VAS)评分:A组<B组<C组<D组,差异均有统计学意义(P<0.05)。咳嗽VAS评分:术后8、24、48 h,A组咳嗽VAS评分小于B组,差异有统计学意义(P<0.05)。声嘶VAS评分:术后8、24、48 h,A组声嘶VAS评分均小于B组,C组和对照组,差异有统计学意义(P<0.05)。咽喉部黏膜反应分级结果:A组<B组<C组<D组。结论全身麻醉甲状腺良性肿物切除手术患者术后应用布地奈德雾化吸入比使用地塞米松雾化可更快速缓解咽喉部并发症。术前预防应用布地奈德雾化吸入能够有效减轻由于全身麻醉气管插管引起的咽喉部损伤。Objective To observe anesthesia in patients with thyroid surgery in preventing atomized inhalation budesonide after throat symptoms improve the situation. After evaluating different ways of atomization inhalation in patients with tracheal intubation throat symptoms and signs of curative effect. Methods One hundred and twenty cases of general anesthesia downlink endotracheal intubation surgical resection of thyroid benign patients were randomly divided into four groups, each group of 30 only：group A：n=30, budesonide 1 mg preoperative 1 h, budesonide 1 mg postoperative 8, 24 and 48 h for atomization inhalation; group B： n=30, budesonide 1 mg postoperative 8, 24 and 48 h take atomization inhalation;group C： n=30, postoperative period shall be 5 mg dexamethasone and 10 mL saline for aerosol inhalation;group D： n=30, postoperative period shall be 10 mL saline for aerosol inhalation. Patient to sitting or semi supine position, all with oxygen as the driving force atomization inhalation, atomizer vertical to the ground, atomization time for 5 min.Observation each group patients postoperative throat situation, evaluating different ways for after atomized inhalation of patients with trachea intubation throat symptoms and signs of curative effect. Results Pharynx pain VAS score： A〈B〈C〈D, the difference had statistical significance （P〈0.05）. Cough VAS score：group A postoperative 8, 24 and 48 h, cough VAS score less than group B, statistically significant difference （P〈0.05）. Voice hoarse VAS score： postoperative 8, 24 and 48 h, voice hoarse VAS score in group A were less than group B, C group and the control group, the difference was statistically significant （P〈0.05）. Throat mucosa reaction classification result A〈B〈C〈D. Conclusion General anesthesia in patients with benign thyroid surgery postoperative budesonide aerosol inhalation atomization can be faster than using dexamethasone relieve throat complications. Preoperative prevention use budesonide aerosol inhalation can effe

关 键 词：手术后并发症 布地奈德 雾化吸入 通气管插入 

分 类 号：R736.1[医药卫生—肿瘤]