加强型气管导管与普通气管导管对行鼻内镜手术患者的影响  

The influence of reinforced tracheal tube and ordinary tracheal tube on patients undergoing endoscopic sinus surgery

作　　者：赵渊 陈彪[2] ZHAO Yuan;CHEN Biao(Graduate of 2018 Grade,Baotou Medical College,Baotou 014010,China;The First Affiliated Hospital of Baotou Medical College)

机构地区：[1]内蒙古科技大学包头医学院,内蒙古包头014010 [2]内蒙古科技大学包头医学院第一附属医院

出　　处：《包头医学院学报》2021年第2期3-6,21,共5页Journal of Baotou Medical College

摘　　要：目的:观察加强型气管导管与普通气管导管对于行鼻内镜手术患者术中及术后的应激反应与咽喉部有无不同影响。方法:选择择期行鼻内镜手术患者68例,年龄18~75岁,ASA分级Ⅰ~Ⅱ级。随机分为加强型气管导管组(A组)和普通气管导管组(B组),A组35例,B组33例。两组均使用可视喉镜进行气管插管操作且一次成功,排除多次插管的病例。比较A、B两组患者入室时(T1)、麻醉诱导前(T2)、插管后手术开始前(T3)、手术结束前(T4)以及手术结束拔管前(T5)的心率、血压、脉氧饱和度、气道压;麻醉诱导前(T2)和插管后手术开始前(T3)两个时间点的血浆皮质醇浓度和血糖。记录手术后患者返回病房时(T6)、第一次饮水(T7)、第一次进食(T8)、术后12 h(T9)以及术后24 h(T10)咽喉部有无疼痛,有无吞咽困难,有无其他不适等情况,疼痛指标以VAS视觉评分指标进行判断(0分不痛,10分最痛)。结果:A、B两组患者之间术中生命体征变化相比较无明显差异(P>0.05)。A组插管后皮质醇水平低于B组,差异有统计学意义(P<0.05),插管前后A、B两组患者血糖变化无统计学差异(P>0.05)。术后12 h时B组咽喉部疼痛评分明显高于A组,术后24 h时两组患者的咽喉部疼痛评分差异无统计学意义。结论:与普通气管导管相比,加强型气管导管对于行鼻内镜手术患者在气管插管时不良刺激引起的应激反应更低,且术后咽喉痛的发生率以及疼痛强度低于普通气管导管。Objective: To observe whether reinforced tracheal tube and ordinary tracheal tube have different effects on the intraoperative and postoperative stress response and the throat of patients undergoing endoscopic sinus surgery. Methods: 68 patients with elective endoscopic sinus surgery, aged 18 to 75 years old, were selected for ASA classification Ⅰ to Ⅱ. They were randomly divided into reinforced tracheal tube group(group A) and ordinary tracheal tube group(group B). There were 35 cases in group A and 33 cases in group B. Both groups used video laryngoscopes for endotracheal intubation and were successful at one time. Multiple intubation cases were excluded. The heart rate, blood pressure, heart rate, pulse oxygen saturation and airway pressure of patients in groups A and B were compared at the time of entering the room(T1), before induction of anesthesia(T2), after intubation and before surgery(T3), after surgery(T4) and before extubation(T5);plasma cortisol concentration and blood glucose level at two time points before induction of anesthesia(T2) and after intubation(T3) were compared. The throat pain, dysphagia, and other discomforts were recorded at the patient’s return to the ward after the operation(T6), the first drinking(T7), the first eating(T8), 12 hours after the operation(T9), and 24 hours after the operation(T10). The pain index is judged by VAS vision(0 points are not painful, 10 points are the most painful). Results: There was no significant difference in the changes of intraoperative vital signs between A and B groups(P>0.05). Compared with group B, the level of cortisol after intubation in group A was lower than that in group B, the difference was statistically significant(P<0.05);there was no significant difference in blood glucose changes between groups A and B before and after intubation(P>0.05). The throat pain score of group B was significantly higher than that of group A at 12 hours after surgery, and there was no significant difference in throat pain scores between the two groups at

关 键 词：加强型气管导管 普通气管导管 鼻内镜手术 应激反应 术后 咽喉痛 

分 类 号：R47[医药卫生—护理学]