雾化吸入布地奈德混悬液联合气管导管涂抹达克罗宁胶浆对改善妇科腹腔镜手术气管插管全身麻醉患者咽喉部不适作用  

Improvement effect of budesonide suspension for aerosol inhalation combined with dyclonine mucilage smearing with tracheal catheter on pharyngeal discomfort in patients undergoing gynecological laparoscopic surgery and tracheal intubation under general anesthesia

作　　者：黄来明 张旭东 Huang Laiming;Zhang Xudong(Department of Anesthesiology,People's Hospital of'Luzhai,Liuzhou 545699,Guangzi Zhuang Autonomous Region,China;Department of Anesthesiology,Liuzhou People's Hospital,Liuzhou 545000,Guangri Zhuang Autonomous Region,China)

机构地区：[1]鹿寨县人民医院麻醉科,广西柳州545699 [2]柳州市人民医院麻醉科,柳州1545000

出　　处：《中华妇幼临床医学杂志（电子版）》2023年第4期480-486,共7页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z-B20221629)。

摘　　要：目的:探讨布地奈德混悬液雾化吸入联合气管导管涂抹达克罗宁胶浆,在妇科腹腔镜手术气管插管全身麻醉患者中减少咽喉部不适的作用。方法:选择2021年1月至2023年1月,于鹿寨县人民医院接受妇科腹腔镜手术时,采用气管插管全身麻醉的200例患者为研究对象。采用随机数字表法,将其随机分为观察组(n=100,采用布地奈德混悬液雾化吸入联合气管导管涂抹达克罗宁胶浆)和对照组(n=100,采用气管导管涂抹达克罗宁胶浆)。采用前瞻性研究方法,观察2组接受妇科腹腔镜手术气管插管全身麻醉患者手术时间、气管导管带管时间及拔管后咽喉部不适症状发生情况等指标。分别于拔管即刻(T0)及拔管后1、6、24、48、72 h(T1、T6、T24、T48、T72),采用疼痛视觉模拟评分(VAS)对2组患者咽喉痛、咽喉部异物感和声嘶3种咽喉症状进行评分;采用世界卫生组织(WHO)咽喉部黏膜反应评分,评估2组患者咽、喉黏膜反应。采用双因素重复测量方差分析,对2组患者6个时间点(T0、T1、T6、T24、T48、T72)咽、喉黏膜反应评分进行比较;采用Mann-Whitney U检验,对2组患者6个时间点的3种咽喉症状VAS评分,分别进行组内及组间比较。本研究经鹿寨县人民医院伦理委员会批准(审批文号:202012KD002)。患者及家属对治疗均知情同意,并签署知情同意书。结果:①2组接受妇科腹腔镜手术患者T0时,咽喉痛及声嘶VAS评分比较,差异均无统计学意义(P>0.05);观察组患者T0时,咽喉部异物感VAS评分低于对照组,并且差异有统计学意义(P<0.05)。②观察组患者T1、T6、T24、T48、T72时,咽喉痛、咽喉部异物感和声嘶3种咽喉症状VAS评分,均分别低于对照组,并且差异均有统计学意义(P<0.05)。③观察组患者T0、T1、T6、T24、T48、T72时,3种咽喉症状VAS评分分别进行组内比较,差异均有统计学意义(P<0.001);对照组亦然。④2组患者T0、T1、T6、T24、T48、T72Objective:To explore the improvement effect of budesonide suspension for aerosol inhalation combined with dyclonine mucilage smearing with tracheal catheter on pharyngeal discomfort in patients undergoing gynecological laparoscopic surgery and tracheal intubation under general anesthesia.Methods:A total of 200 patients undergoing tracheal intubation under general anesthesia during gynecological laparoscopy in the People′s Hospital of Luzhai were enrolled as the research objects from January 2021 to January 2023.According to random number table method,they were divided into observation group(n=100,budesonide suspension for aerosol inhalation combined with dyclonine mucilage smearing with tracheal catheter)and control group(n=100,dyclonine mucilage smearing with tracheal catheter).By prospective research methods,the operation time,tracheal intubation time and occurrence of pharyngeal discomfort after extubation in both groups were observed.Immediately after extubation(T0),and at 1,6,24,48 and 72 h after extubation(T1,T6,T24,T48,T72),pharyngeal symptoms(sore throat,foreign body sensation in throat,hoarseness)were scored by visual analogue scale(VAS).The mucosal responses of pharynx and larynx were evaluated by scores of the World Health Organization(WHO)pharyngeal and laryngeal mucosal responses.The scores of pharyngeal and laryngeal mucosal responses of two groups at the 6 time points(T0,T1,T6,T24,T48,T72)were compared by double-factor repeated measure ANOVA.The intra-group and inter-group comparison of VAS scores of three kinds of throat symptoms in two groups at the 6 time points were conducted by Mann-Whitney U test.This study was approved by the Ethics Committee of the People′s Hospital of Luzhai(Approval No.202012KD002).Patients and their families gave informed consent to the treatment and signed informed consent forms.Results:①There were no significant differences in VAS scores of sore throat and hoarseness between two groups at T0(P>0.05).The VAS score of pharyngeal foreign body sensation at T0 in obse

关 键 词：布地奈德 达克罗宁 妇科外科手术 腹腔镜检查 插管法 气管内 麻醉 全身 咽部不适 

分 类 号：R614[医药卫生—麻醉学]