视频喉镜气管插管对甲状腺手术后咽喉痛的影响  

The Effect of Video Laryngoscope Tracheal Intubation on Sore Throat after Thyroid Surgery

作　　者：张见岗 杨磊 刘洋 ZHANG Jiangang;YANG Lei;LIU Yang(The Affiliated Jiangning Hospital of Nanjing Medical University,Nanjing 211100,China)

机构地区：[1]南京医科大学附属江宁医院麻醉科,江苏南京211100

出　　处：《湖北民族大学学报（医学版）》2022年第1期40-43,共4页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的观察视频喉镜下气管插管对甲状腺手术后咽喉痛(POST)的影响。方法选取行甲状腺手术患者104例,按照数字随机方法分为直接喉镜组和视频喉镜组,每组各52例,直接喉镜组使用Macintosh(MCL)直接喉镜进行,视频喉镜组采用类似GlideScope视频喉镜,全麻下进行甲状腺切除手术,观察两组患者手术时间、气管插管时间、术中芬太尼的总用量,记录气管插管中插管次数和需要外部按压患者的次数,患者进入麻醉恢复室(PACU)后记为即刻,6 h,12 h和24 h分别采用视觉模拟(VAS)评分,记录即刻,6 h,12 h和24 h各时点出现POST例数。结果两组患者手术时间和术中芬太尼总用量比较,差异无统计学意义(P>0.05),视频喉镜组插管时间短于直接喉镜组(P<0.05);视频喉镜组一次插管成功率明显高于直接喉镜组(χ^(2)=17.648,P=0.005);视频喉镜组需要外部按压次数比率明显低于直接喉镜组(χ^(2)=19.674,P=0.006);视频喉镜组在即刻,6 h,12 h时点VAS评分均明显低于直接喉镜组(P<0.05);术后即刻和6 h时点视频喉镜组患者POST发生率明显低于直接喉镜组(χ^(2)=8.634,P=0.001,χ^(2)=7.957,P=0.017)。结论与MCL直接喉镜相比,常规使用视频喉镜进行气管插管置入术可降低术后POST发生率,降低POST疼痛的严重程度。Objective To compare the effects of endotracheal intubation under video laryngoscope on sore throat(POST)after thyroid surgery.Methods 104 patients undergoing thyroid surgery were selected as the research objects,and divided into the MCL group and the GL group according to the numerical randomization method,with 52 cases in each group.The MCL group used a Macintosh(MCL)direct laryngoscope,and the GL group used a similar GlideScope video laryngoscope.The thyroidectomy was performed under general anesthesia.The operation time,tracheal intubation time,and the total amount of fentanyl during the operation were observed in the two groups.The number of tracheal intubations and external compressions of the patient were recorded.After entering the anesthesia recovery room(PACU),the patients were recorded as immediate time.Visual analogue(VAS)scores were used at 6 h,12 h and 24 h,respectively.The number of POST cases was recorded at immediate time,6 h,12 h and 24 h.Results The intubation time of the GL group was significantly shorter than that of the MCL group(P<0.05).The success rate of one-time intubation in the GL group was significantly higher than that in the MCL group(χ^(2)=17.648,P=0.005),and the rate of external compressions required in the GL group was significantly lower than that in the MCL group(χ^(2)=19.674,P=0.006).The VAS scores in the GL group were significantly lower than those in the MCL group at the immediate time and 6 h,12 h(P<0.05).The incidence of POST in the GL group at immediate time and 6 h after the operation was significantly lower than that in the MCL group(χ^(2)=8.634,P=0.001,χ^(2)=7.957,P=0.017).Conclusion Compared with MCL direct laryngoscope,the use of video laryngoscope for tracheal intubation can reduce the incidence of postoperative POST and severity of POST pain.

关 键 词：术后咽喉痛(POST) 气管插管 GLIDESCOPE视频喉镜 甲状腺手术 

分 类 号：R653[医药卫生—外科学]