甲状腺手术患者术后咽喉部干痛的相关影响因素分析  

Related factor analysis on sore throat and pharyngeal xeransis during thyroid surgery

作　　者：彭婷[1] 罗爱林[1] 韩东吉[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉科,武汉市430030

出　　处：《临床麻醉学杂志》2017年第6期576-578,共3页Journal of Clinical Anesthesiology

摘　　要：目的研究影响甲状腺手术患者术后咽喉部干痛的相关因素。方法选择择期行甲状腺手术的女性患者29例,年龄24~67岁,BMI 18~30kg/m2,ASAⅠ或Ⅱ级。麻醉诱导及气管插管后将套囊充气至20mm Hg,采用压力传感器持续动态监测气管导管套囊压力,每间隔5分钟记录实时数据,并于术后24h评估患者咽痛评分和咽干分级。结果气管导管套囊压力值呈离散分布。多元线性回归模型分析结果显示,年龄、BMI、麻醉时间、套囊压力对咽痛评分均无明显影响;决策树模型分析结果显示,甲状腺手术套囊平均压力≥29 mm Hg时,患者咽干分级为Ⅳ级的几率较高。结论甲状腺手术患者咽干的发生可能与手术操作导致气管导管的套囊压力增高相关。Objective To explore the related factors on sore throat and pharyngeal xeransis during thyroid surgery. Methods Twenty-nine female patients, aged 24-67 years, BMI 18-30 kg/m^2 , falling into ASA physical status Ⅰ or Ⅱ , were scheduled for thyroid surgery. After anesthesia induction and tracheal intubation, the endotracheal intracuff was inflated to 20 mm Hg. Intracuff pressure was monitored every 5 minutes by a pressure transducer. At the time of 24 hours after tracheal intu-bation, the patients were asked about their throat complaints such as sore throat and pharyngeal xeransis. Results Endotracheal intracuff pressure during thyroid surgery was in a discrete distribution. Multiple linear regression model analysis found that age, BMI, anesthesia time and intracuff pressure had no obvious effects on sore throat. Decision tree model analysis found that patients undergoing thy-roid surgery had higher probability of pharyngeal xeransis grade IV, when the average intracuff pres sure was higher than 29 mm Hg. Conclusion Excessive endotracheal intracuff pressure during thyroid surgery due to operation causes pharyngeal xeransis.

关 键 词：甲状腺手术 套囊压力 咽痛 咽干 动态监测 

分 类 号：R614[医药卫生—麻醉学]