甲状腺手术与乳腺手术中气管导管套囊压力及术后咽部并发症对比  

Comparison of intraoperative endotracheal intracuff pressure and postoperative throat complications in thyroidectomy versus mastectomy

作　　者：房祥峰 罗爱林[1] 韩东吉 彭婷 刘天柱 FANG Xiangfeng, LUO Ailin, HAN Dongji, PENG Ting, LIU Tianzhu(Department of Anethesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Chin)

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉学教研室,湖北武汉430030

出　　处：《麻醉安全与质控》2018年第4期193-195,共3页Perioperative Safety and Quality Assurance

摘　　要：目的持续记录甲状腺手术和乳腺手术中气管导管套囊压力值,评估并对比患者术后咽痛咽干程度。方法选取华中科技大学同济医学院附属同济医院2016-03/2016-04期间经排除标准筛选后50例甲乳外科手术患者入组,按手术方式分为甲状腺手术组(n=23)和乳腺手术组(n=27),ASA分级Ⅰ～Ⅱ级。甲状腺手术组,女性,年龄24～66岁,体质量指数(BMI)18～30 kg/m^2;乳腺手术组,女性,年龄30～67岁,BMI 17～30 kg/m^2。麻醉诱导并顺利插管后将气管导管套囊压力充气至20 mm Hg(28 cm H2O),持续观察套囊压力变化,每5 min记录实时压力值。术后24 h随访评估患者咽痛视觉模拟评分(VAS)和咽干分级。结果甲状腺手术组的平均套囊压力比乳腺手术组高(P<0.05),同时,术后甲状腺手术组患者咽痛VAS更高(P<0.05)、咽干分级更高(P<0.05)。结论在起始气管导管套囊充气压力相等的条件下,与乳腺手术相比,甲状腺手术术中气管导管的套囊压力更高,患者术后咽痛咽干程度更重。Objective To compare endotracheal intracuff pressure and postoperative throat complications in thyroidectomy and mastectomy.Methods Twenty-three female patients scheduled for thyroidectomy,age 24-66 years,body mass index（ BMI） 18-30 kg/m2,ASAⅠ-Ⅱ,were enrolled in this study. Twenty-seven female patients scheduled for mastectomy,age 30-67 years,BMI 17-30 kg/m2,ASA Ⅰ-Ⅱ,were enrolled in this study. After tracheal intubation,the endotracheal intracuff was inflated to 20 mm Hg（ 28 cm H2 O）.Intracuff pressure was recorded every 5 min by a pressure transducer. At 24 h after tracheal intubation,patients were asked about the throat complications such as sore throat and pharyngeal xeransis. Results The thyroidectomy patients showed a higher intracuff pressure than that of mastectomy patients with the initial intracuff pressure being the same（ P〈0. 05）,with higher VAS pain score（ P〈0. 05）and higher pharyngeal xeransis grade（ P〈0. 05）. Conclusion Compared with mastectomy,excess endotracheal intracuff pressure during thyroidectomy,likely due to the surgical procedure,is associated with more postoperative throat complications.

关 键 词：套囊压力 动态监测 甲状腺手术 乳腺手术 气管插管并发症 

分 类 号：R614[医药卫生—麻醉学]