视频喉镜联合地塞米松乳膏对气管插管术后咽喉并发症的影响

Effect of dexamethasone cream combined with videolaryngoscopy on postoperative laryngopharyngeal complications in patients undergoing tracheal intubation

目的:观察视频喉镜联合地塞米松乳膏涂抹导管对气管插管术后咽喉并发症的影响。方法:120例ASAⅠ或Ⅱ级拟行插管全麻的患者,随机分为3组(n=40),A组采用视频喉镜联合地塞米松乳膏涂抹导管前端插管,B组仅采用视频喉镜插管,C组采用传统Macintosh喉镜插管。记录声门显露分级、插管时间、一次插管成功率、喉镜和套囊带血情况及术后30 min、24 h、48 h、72 h咽喉并发症的发生率。结果:与C组比较,A、B组的声门分级明显降低,声门暴露明显改善,一次插管成功率明显提高,喉镜带血情况明显减少,术后咽喉疼痛、吞咽困难发生率明显减少(P<0.05);与B组比较,A组套囊带血情况明显减少,术后声音嘶哑、咳嗽、咳痰的发生率明显减少(P<0.05)。结论:视频喉镜联合地塞米松乳膏可有效地减少气管插管术后咽喉并发症的发生。

Objectives To investigate the effect of dexamethasone cream combined with videolaryngoscopy on postoperative laryngopharyngeal complications in patients undergoing tracheal intubation. Methods One hundred and twenty patients undergoing general anesthesia with intubation, ASA Ⅰ or Ⅱ, were randomly enrolled into three groups as follows （n = 40 for each group）, patients in group A were intubated with tracheal catheter coated with dexamethasone cream under videolaryngoscopy, patients in group B were intubated under video laryngoscope only, and patients in group C were intubated under traditional Macintosh laryngoscope. The classification of glottis exposure, time of intubation, cases of the successful intubation for first try, laryngoscope and cuff with blood, and incidence of laryngopharyngeal complications were recorded at 30 min, 24 h, 48 h, 72 h post operation. Results Compared with group C, the classification of glottis exposure of patients in group A and B were obviously reduced, while the glottic exposure significantly improved, cases of the successful intubation for first try were obviously improved, and laryngoscopes with blood were significantly reduced, the incidence of postoperative sore throat and swallowing in difficulty were significantly reduced （P 〈 0.05, respectively）. Compared with group B, cases of cuff with blood in group A were significantly reduced, the incidence of postoperative hoarseness, cough, sputum were significantly decreased （P 〈 0.05, respectively）. Conclusions Intubation with tracheal catheter coated with dexamethasone cream under videolaryngoscopy can effectively decrease the incidence of laryngopharyngeal complications .