甲基强的松龙预防气管插管拔管后咽喉部并发症的效果研究

Effect of Methylprednisolone on Throat Complications after Tracheal Extubation

目的探讨甲基强的松龙预防气管插管拔管后咽喉部并发症的效果。方法 2011年1月—2012年8月选择北京大学第三医院急诊重症监护病房收治的需气管插管患者104例。按入院时间不同将2011年1月—2012年1月收治的患者作为A组(47例),2012年2—8月收治的患者作为B组(57例)。A组拔管前使用地塞米松,B组拔管前使用甲基强的松龙。观察两组患者气管插管拔管后咽喉部并发症(咽部疼痛、声音嘶哑、喉头水肿等)的发生情况。结果 A组咽部疼痛发生率为44.7%(21/47)、声音嘶哑发生率为38.3%(18/47)、喉头水肿发生率为4.2%(2/47);B组咽部疼痛发生率为28.1%(16/57)、声音嘶哑发生率为22.8%(13/57)、喉头水肿发生率为3.5%(2/57)。两组咽部疼痛、声音嘶哑及喉头水肿发生率比较,差异均无统计学意义(P>0.05)。结论气管插管拔管前使用甲基强的松龙可能减少拔管后患者并发症的发生率,为临床进一步研究提供了参考依据。

Objective To investigate the effect of methylprednisolone on throat complications after tracheal extubation. Methods From January 2011 to August 2012,104 patients admitted to intensive care units（ ICU） of Peking University Third Hospital who needed tracheal intubation were divided,according to admission time,into groups A（ admitted from January2011 to January 2012,n = 47）,B（ admitted from February to August in 2012,n = 57）. Group A were given dexamethasone,group B given methylprednisolone before extubation. The incidences of throat complications（ pharyngeal pain,hoarseness,laryngeal edema,etc.） were observed after tracheal extubation. Results In group A,the incidence of pharyngeal pain was 44. 7%（ 21/47）,that of hoarseness was 38.3%（ 18/47）,that of laryngeal edema was 4.2%（ 2/47）,and in group B,28.1%（ 16/57）,22.8%（ 13/57）,3.5%（ 2/57）,respectively; the difference was not significant（ P 〉0.05）. Conclusion Pre- extubation methylprednisoline can reduce the incidence of complications,which provides references for further clinical study.