双腔气管插管患者术后咽喉痛的危险因素分析  

Risk Factors for Postoperative Sore Throat in Patients with a Double-lumen Endotracheal Tube

作　　者：李瑛园 关健强[1] 黑子清[1] 杨基荣 冉涛嘉 黄品婕[1] LI Yingyuan;GUAN Jianqiang;HEI Ziqing;YANG Jirong;RAN Taojia;HUANG Pinjie(Department of Anesthesiology,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院麻醉科,广东广州510630

出　　处：《中山大学学报（医学科学版）》2024年第1期121-126,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省自然科学基金(2021A1515011827)。

摘　　要：【目的】探讨拔管力等因素是否是双腔气管插管术后咽喉痛的危险因素。【方法】这是一项随机对照试验的事后分析。本研究收集18~65岁,ASAI-Ⅲ级的双腔气管插管患者围术期资料,记录性别、年龄、吸烟史、导管直径、导管留置时间、舒芬太尼用量、是否使用氟比洛芬酯、是否拔管时呛咳等。拔管时使用测力计测量拔除导管所需的力。根据术后是否发生咽喉痛分为咽喉痛组和无咽喉痛组。对两组资料进行组间比较和多因素logistic回归分析,筛选术后咽喉痛的危险因素。使用ROC曲线预测危险因素的预测效应。【结果】最终纳入163例患者,拔管后30 min有74例(45.4%)患者发生术后咽喉痛,89例(54.6%)患者未发生术后咽喉痛。多因素logistic回归分析结果显示女性[OR95%CI=3.83(1.73,8.50),P=0.0001]和拔管力增大[OR95%CI=1.78(1.45,2.20),P<0.001]是术后咽喉痛的独立危险因素。拔管力预测术后咽喉痛的AUC曲线为0.773[95%CI(0.701,0.846),P<0.001];当约登指数为0.447时,拔管力的最佳临界点是13N。【结论】女性和拔管力是双腔气管插管全身麻醉术后咽喉痛的独立危险因素。【Objective】To investigate risk factors for postoperative sore throat in patients with double-lumen endotracheal intubation.【Methods】The data used in this post-hoc analysis were prospectively collected from a randomized,controlled trial.Age from 18 to 65 years old,ASAI-Ⅲpatients undergoing general anesthesia with a double-lumen endotracheal tube were enrolled.The perioperative data collected retrospectively were as follows:gender,age,smoking history,endotracheal tube diameter,duration of endotracheal tube,dose of Sufentanil,use of Flurbiprofen Axetil,cough after extubation,etc..Dynamometer was applied to assess extubation force.According to occurrence of postoperative sore throat,patients were divided into two groups:those who experienced sore throats and those who did not.Comparative analysis and multivariate logistic regression analysis were performed to screen the risk factors.ROC curve was used for predicting the predictive value of risk factors.【Results】Among the 163 patients,74(45.4%)had postoperative sore throat vs 89(54.6%)not had.Multivariate logistic regression showed female[OR95%CI=3.83(1.73,8.50),P=0.0001]and extubation force[OR95%CI=1.78(1.45,2.17),P<0.001]were independent risk factors for postoperative sore throat.AUC value showed the extubation force was 0.773[95%CI(0.701,0.846),P<0.001].Youden index was 0.447,and the cut-off valve of extubation force was 13N.【Conclusion】Female and extubation force were risk factors for sore throat in patients with double lumen endotracheal intubation.

关 键 词：双腔气管插管 术后咽喉痛 危险因素 气管拔管 拔管力 全身麻醉 

分 类 号：R614.2[医药卫生—麻醉学]