气管导管套囊内注入利多卡因预防气管插管全麻术后患者气道并发症的系统评价  

Prevention of Post Intubation Airway Complications by Inflating Endotracheal Tube Cuff with Lidocaine:A Systematic Review

作　　者：黎安良 高鸿[1] 林少锋[1] 刘艳秋[1] 

机构地区：[1]贵州医科大学,贵阳550004

出　　处：《循证医学》2016年第2期109-115,124,共8页The Journal of Evidence-Based Medicine

摘　　要：目的系统评价通过气管导管套囊内注入利多卡因预防气管插管全麻术后患者咽喉痛、呛咳及声音嘶哑的效果。方法采用Cochrane系统评价方法,计算机检索The Cochrane Library、PubMed、EMBASE、CNKI和Wanfang Data数据库,同时手工检索图书馆馆藏期刊,收集有关套囊内注入利多卡因预防全麻患者术后咽喉痛的随机对照试验,检索时限均截止于2015年10月。由两位研究者按照纳入与排除标准筛选文献、提取资料和评价质量,然后采用RevMan 5.1软件进行Meta分析。结果最终纳入15个随机对照试验,共982例患者。Meta分析结果显示:1咽喉痛发生情况:在术后1 h内咽痛发生人数试验组少于对照组[比值比=0.31,95%可信区间(0.17,0.57),P=0.000 2];术后24 h内咽痛发生人数试验组少于对照组[比值比=0.34,95%可信区间(0.17,0.68),P=0.002]。2术后咽痛严重程度评分:术后1 h内咽痛严重程度评分试验组低于对照组[加权均数差=-18.08,95%可信区间(-26.05,-10.11),P<0.000 01];术后24 h咽痛严重程度评分试验组低于对照组[加权均数差=-10.11,95%可信区间(-12.13,-8.08),P<0.000 01]。3术后苏醒期呛咳发生情况:试验组呛咳发生人数较少[比值比=0.26,95%可信区间(0.13,0.53),P=0.000 2]。4术后24 h声音嘶哑发生情况:试验组声音嘶哑发生人数较少[比值比=0.29,95%可信区间(0.11,0.75),P=0.01]。结论术中通过气管导管套囊内注入利多卡因可以有效预防术后全麻气管插管患者咽喉痛、声音嘶哑及呛咳的发生。Objective To systematically review preventive effect that intracuff Lidocaine used in patients receiving general anesthesia endotracheal intubation is associated with significantly reduced incidence of postoperative sore throat,cough and hoarseness. Methods Using the Cochrane systematic review methods,we searched the Cochrane Controlled Trial Registers（CCTR）of the Cochrane Library,PubMed,EMBASE,CNKI and Wanfang databases from inception to October 2015. We also handsearched relevant journals and conference proceedings. Two reviewers independently selected studies and assessed the quality of the trials. Disagreements were resolved by discussion,in consultation with a third reviewer. Then,meta-analysis was performed using Rev Man 5.1 software. Results Thirteen trials involving 982 patients were finally included. Meta analysis results show that the number of sore throat that occurred in the postoperative 1 h in the test group were less than the control group[OR=0.31,95%CI（0.17,0.57）,P=0.000 2];the number of test group postoperative sore throat in 24 h occurred less than the control group[OR=0.34,95%CI（0.17,0.68）,P=0.002]. The severity score of postoperative sore throat in the 1 h was less in test group than in control group[WMD=-18.08,95%CI（-26.05,-10.11）,P〈0.000 01];The severity score of postoperative sore throat in the 24 h was less in test group than in control group[WMD=-10.11,95%CI（-12.13,-8.08）,P0.000 01]. The incidence of cough in the recovery period was compared with control group,and the incidence of cough in the experimental group was less than control group[OR=0.26,95%CI（0.13,0.53）,P=0.000 2]. In postoperative 24 h,the incidence of hoarseness in the test group occurred less[OR=0.29,95%CI（0.11,0.75）,P=0.01]. Conclusion The intracuf Flidocaine can be effective in preventing postoperative sore throat,hoarseness and choking cough for general anesthesia under tracheal intubation patients.

关 键 词：利多卡因 套囊内 咽喉痛 系统评价 

分 类 号：R614.2[医药卫生—麻醉学]