颈椎前路手术后患者麻醉苏醒期吸痰方式的前瞻性随机对照研究  

Sputum Aspiration Methods During Anesthesia Recovery in Patients After Anterior Cervical Surgery: a Prospective Randomized Controlled Study

作　　者：郑虹彩[1] 邓述华[1] 李扬煜 李淼[1] 姚瑶[1] Zheng Hongcai;Deng Shuhua;Li Yangyu(Department of Anesthesiology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院麻醉科

出　　处：《中国微创外科杂志》2019年第11期969-972,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：北京大学第三医院2016年护理科研基金(2016117)

摘　　要：目的探讨颈椎前路手术后在麻醉恢复室苏醒期间不同吸痰方式对患者血流动力学、呛咳发生率及切口引流量的影响。方法2018年1~7月选择168例脊髓型颈椎病全身麻醉颈椎前路手术,手术结束后带气管导管进入麻醉恢复室苏醒,随机数字表分为2组,A组采用口咽部吸痰方式,B组采用气管导管+口咽部吸痰方式。比较2组患者麻醉苏醒期间心率、血压、血氧饱和度(SpO 2)、吸痰呛咳发生率、切口引流量和患者苏醒满意度。结果2组患者麻醉苏醒期收缩压、舒张压、平均动脉压、心率和SpO 2组间和组间与时间的交互作用差异无显著性(P>0.05),但组内不同时间点差异有显著性(P<0.05)。A组患者吸痰呛咳发生率(χ^2=6.685,P=0.010)、切口引流量增加的例数(Fisher精确检验,P=0.001)均明显低于B组。2组患者苏醒满意度差异无统计学意义(Fisher精确检验,P=0.497)。结论颈椎前路手术后患者麻醉苏醒期采用口咽部吸痰方式,切口引流量少,吸痰呛咳发生率低,值得推广应用。Objective To explore the effect of sputum suction in different ways in patients after cervical vertebra surgery during anesthesia recovery.Methods After general anesthesia,168 patients with cervical spondylotic myelopathy who came into anesthesia recovery room after cervical anterior cervical surgery were divided into two groups by random number scale.The tracheal catheter was extracted by oropharyngeal suction in group A,and the tracheal tube was removed by tracheal catheter plus oropharyngeal suction in group B.The heart rate,blood pressure,blood oxygen saturation(SpO 2),cough after extubation rate,incisional drainage volume and patients’satisfaction were recorded during anesthesia recovery.Results There was no significant difference in systolic blood pressure,diastolic blood pressure,mean blood pressure,SpO 2 and patients’satisfaction between the two groups and interaction between groups and time during the recovery period after anterior cervical surgery(P>0.05).There were significant differences at different time points in the same group(P<0.05).The incidence of cough after extubation(χ^2=6.685,P=0.010)and patients who had increased incisional drainage volume(Fisher’s exact test,P=0.001)in the group A were significantly lower than those in the group B(P<0.05).There was no statistical difference in patients’satisfaction between the two groups(Fisher’s exact test,P=0.497).Conclusions During the recovery period after anterior cervical surgery,the oropharyngeal sputum suction method can reduce the incidence of cough and amount of incisional drainage volume.It is worthy of popularizing and applying in clinical nursing.

关 键 词：颈椎前路手术 麻醉苏醒期 吸痰方式 

分 类 号：R61[医药卫生—外科学]