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论著:气管导管套囊压力与患者气道黏膜损伤程度的关系
Effects of Tracheal Cuff Pressure on Tracheal Mucosal Damage in Patients with Intubation
孙霞 陈家伟 尹华 谭志明
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作者单位:复旦大学附属肿瘤医院麻醉科
中文关键字:套囊压力;气管黏膜;咽痛;发声困难
英文关键字:Cuff pressure; Tracheal mucosa; Sore throat; Dysphonia
中文摘要:目的:探讨气管导管套囊压力的变化对患者气道黏膜损伤程度的影响。方法:择期行妇科肿瘤手术患者共80例,年龄18~65岁,身高155~165 cm,体质量指数(BMI)18~23 kg/m2,美国麻醉医师协会(ASA)分级为I~II级,随机分为2组:持续压力组(A组)和压力变化组(B组),每组40例。A组气管插管后维持气管导管套囊压力于25 mmHg直至手术结束。B组气管插管后维持气管导管套囊压力于25 mmHg,每隔1 h套囊放气至10 mmHg压力,维持10 min后,再次充气至25 mmHg。拔管后记录气管导管套囊有无带血,患者有无咽喉痛、刺激性咳嗽、气道痉挛及发声困难。结果:2组患者术后各项气道并发症发生率的差异均无统计学意义(P>0.05)。结论:全麻过程中气管导管套囊间断放气不能减轻气管黏膜的损伤,也不会减少咽喉部并发症的发生率。
英文摘要:Objective: To investigate the effects of tracheal cuff pressure on tracheal mucosal damage in patients with intubation. Methods: We obtained informed consent from 80 American Society of Anesthesiologists (ASA) class I or II, body mass index (BMI) 18-23 kg/m2,18-65 year-old patients, who were scheduled for radical treatment of gynaecological cancer. They were randomly allocated to either Group A or Group B. Patients in both groups were placed an epidural catheter at vertebral interspace between T11 and T12. General anesthesia was induced with propofol 1.5-2.0 mg/kg, fentanyl 3-4 μg/kg and rocuronium 0.6-0.8 mg/kg. Anaesthesia was maintained with porpofol and intermittent epidually administration of 0.375% ropovacaine. In Group A, the intracuff pressure was kept at 25 mmHg during the operation. In Group B, the intracuff pressure was kept at 25 mmHg, with intermittent lowered to 10 mmHg for 10 minutes every 60 minutes. Patients were questioned postoperatively about sore throat, dysphonia, and about whether they were satisfied with their anesthetic. Complications after tracheal tube removal, including coughing, bronchospasm, laryngospasm and the presence of blood on the tracheal tube, were recorded. Results: There was no difference in the incidence of complications of tracheal tube removal between two groups (P>0.05). Conclusions: The method of maintaining the intracuff pressure for 1 h with intermitted deflation can not reduce the mucosal damage.
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