摘要
背景与目的：术后咽喉疼痛（postoperative sore throat，POST）是甲状腺癌根治术后患者常见的不适主诉。术中气管插管是导致POST的主要原因。该研究通过比较可视内窥镜插管和普通喉镜插管术后咽痛的发生率，观察不同插管技术对甲状腺癌根治术患者POST的影响。方法：选择拟行甲状腺癌根治术患者100例，年龄18～60岁，美国麻醉医师协会（ASA）分级Ⅰ～Ⅱ级，术前评估无插管困难。根据插管方式不同，随机分为两组（n=50）：可视内窥镜组（A组）和普通喉镜组（B组）。所有患者气管导管气囊压力维持20mmHg。记录患者拔管后1、65和24h咽喉疼痛的视觉模拟评分（visual analogue scale，VAS）、伯格曼舒适度评分（Bruggrmann comfort scale，BCS）以及每组的咽痛例数。结果：A组有21例发生POST，低于B组32例（42％ vs 64％，P=0．027），术后1、6和24h时，A组VAS评分分别为：3．05±1．56、3．05±1．565n2．72±1．77，均低于B组：4．25±1．30、4．01±1．98和3．31±1．12（P〈0．05）；A组BCS评分分别为：0．99±0．46、1．95±0．47和2．82±0．87，均高于B组的0．69±0．30、1．51±0．58和2．31±0．72，差异有统计学意义（P〈0．05）。结论：使用可视内窥镜插管可以降低甲状腺癌根治术患者的POST的发生率。
Background and purpose： Postoperative sore throat （POST） is one of the common complaints of patients after radical thyroidectomy. Tracheal intubation is the main cause of POST. This study compared the effect of intubation with visual endoscopy and general laryngoscope on POST in patients undergoing radical thyroidectomy. Methods： One hundred patients （18-60 years, ASA Ⅰ～Ⅱ） undergoing elective radical thyroidectomy were randomized into two groups： patients in group A （n=50） were intubated with visual endoscope while patients in group B （n=50） were intubated with general laryngoscope. Endotracheal tube cuffs pressure was maintained at 20mmHg in all patients. Visual analogue scale （VAS） and Bruggrmann comfort scale （BCS） were recorded at the time points of 1, 6 and 24 h after extubation. Results： Compared with group B, the incidence of POST in group A was signifcantly reduced （42% vs 64%, P=-0.027）. The VAS of group A was lower than that of group B （3.05±1.56 vs 4.25±1.30, 3.05±1.56 vs 4.01±1.98, 2.72±1.77 vs 3.31±1.12） （P〈0.05）. The BCS of group A was higher than that of group B （0.99±0.46 vs 0.69±0.30, 1.95±0.47 vs 1.51±0.58, 2.82±0.87 vs 2.31±0.72） （P〈0.05）. Conclusion： Using visual endoscopic intuhation can reduce the incidence of the POST in patients undergoing radical thyroidectomy.
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2016年第11期939-942,共4页
China Oncology
