术前应用小剂量地塞米松对甲状腺切除术后咽部不适预防的效果观察  

Effect observation of preoperative low-dose dexamethasone on the prevention of pharyngeal discomfort after thyroidectomy

作　　者：曾晓敏 李洲婷 ZENG Xiaomin;LI Zhouting(Department of General Surgery,Lishui Central Hospital in Zhejiang Province,Lishui 323000,China)

机构地区：[1]浙江省丽水市中心医院普通外科,丽水323000

出　　处：《浙江医学教育》2024年第3期188-191,共4页Zhejiang Medical Education

基　　金：浙江省丽水市科技计划项目:“基于加速康复外科的术前小剂量地塞米松预防性应用对甲状腺术后并发症预防的护理研究”(2019SJZC07)。

摘　　要：目的 评估术前小剂量单次应用地塞米松预防甲状腺切除术后咽部不适的作用。方法 选取2020年3月至2021年3月浙江省丽水市中心医院普通外科诊治的210例甲状腺手术患者为研究对象。采用随机数字表法,将其分为试验组和对照组,每组105名患者。试验组患者于术前半小时静脉滴注地塞米松10 mg+生理盐水100 mL,对照组患者在同一时间静脉滴注同等容积的生理盐水。比较两组患者在甲状腺切除术后咽部不适的发生情况。结果 试验组患者术后恶心呕吐、咳嗽、吞咽疼痛的视觉模拟评分均明显低于对照组患者,其差异均具有统计学意义(均P<0.001);试验组患者术后住院相关指标(包括术后引流液量、住院时间、住院费用)均明显优于对照组患者,其差异均具有统计学意义(均P<0.001);两组患者的年龄、性别、身高、体重、手术方式、术后血钙、切口愈合等情况比较,其差异均无统计学意义(均P>0.05)。结论 实施甲状腺切除术的患者术前单次使用小剂量地塞米松,可以降低术后恶心呕吐、咳嗽发生率,减轻吞咽疼痛感。Objective To evaluate the role of a small single dose of dexamethasone preoperative application for the prevention of post-thyroidectomy pharyngeal discomfort.Methods Two hundred and ten patients admitted to the General Surgery Department of Lishui Central Hospital in Zhejiang Province from March 2020 to March 2021 were selected for the study.They were divided into experimental and control groups,with the experimental group being the dexamethasone group(n=105)and the control group being the saline group(n=105).In the experimental group,dexamethasone 10 mg+saline 100 mL was administered half an hour before surgery,and in the control group,the same volume of saline was administered at the same time point.The occurrence of pharyngeal discomfort in the two groups of patients after thyroid surgery was compared.Results The visual analogue score of postoperative nausea and vomiting,cough and swallowing pain in the experimental group were significantly lower than those in the control group,and the differences were all statistically significant(all P<0.001);the postoperative hospitalization-related indexes(including the amount of postoperative drainage fluid,hospitalization time and hospitalization cost)in the experimental group were significantly better than those in the control group,and the differences were all statistically significant(all P<0.001);the age,gender,height,weight,surgical method,postoperation blood calcium and incision healing in the two groups were compared,and the differences were not statistically significant(all P>0.05).Conclusions Preoperative injection of single-low-dose dexamethasone in patients undergoing thyroidectomy can reduce the incidence of postoperative nausea and vomiting,cough,and painful swallowing.

关 键 词：甲状腺切除术 小剂量地塞米松 咽部不适 预防效果 

分 类 号：R619.5[医药卫生—外科学]