甲强龙静脉途径给药预防气管插管诱发患者咽喉部并发症的有效性

Efficacy of intravenous methylprednisolone for prevention of tracheal intubation-related iaryngopharyngeal complications

目的评价甲强龙静脉途径给药预防气管插管诱发患者咽喉部并发症的有效性。方法选择气管插管全麻手术患者300例，性别不限，年龄20～50岁，体重50～80kg，ASA分级Ⅰ或Ⅱ级，采用随机数字表法，将患者分为5组（n=60），I组：麻醉诱导前30min静脉注射甲强龙40mg；Ⅱ组：麻醉诱导前30min静脉注射甲强龙80mg；Ⅲ组：麻醉诱导前30min静脉注射等容量生理盐水；Ⅳ组：拔管前30min静脉注射甲强龙40mg；Ⅴ组：拔管前30min静脉注射甲强龙80mg。于拔管后24h内记录患者咽喉部并发症发生情况，于拔管后1和24h时评价其严重程度。结果5组患者咽喉部疼痛发生率和程度、声音嘶哑发生率和程度、咳嗽发生率和程度比较差异无统计学意义（P〉0．05）。结论甲强龙静脉途径给药不能有效预防气管插管诱发咽的喉部并发症。

Objective To evaluate the efficacy of intravenous methylprednisolone for prevention of tracheal intubation-related laryngopharyngeal complications. Methods Three hundred ASA I or 1I patients, aged 20- 50 yr, weighing 50-80 kg, undergoing elective surgeries, requiring tracheal intubation under general anesthesia, were included and randomized into 5 groups （ n = 60 each） . Methylprednisolone 40 and 80 nag were injected intravenously at 30 min before induction of anesthesia in groups I and II , respectively, while the equal volume of normal saline was given instead in group II . Methylprednisolone 40 and 80 mg were injected intravenously at 30 min before extubation in groups IV and V , respectively. The sore throat, hoarseness and cough were recorded within 24 h after extubation and the severity was evaluated at 1 and 24 h after extubation. Results There was no significant difference in the incidence and severity of sore throat, hoarseness and cough between the five groups （P 〉 0.05 ）. Conclusion Intravenous methylprednisolone can not effectively prevent tracheal intubation-related laryngopharyngeal complications in patients.