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全麻气管插管术后手术患者咽喉痛的影响因素及治疗进展
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Abstract:
随着医疗技术的发展和加速康复外科理念的提出,气管插管全身麻醉成为大多数手术的首要麻醉方式。术后咽喉痛是全身麻醉气管插管术后的并发症之一,疼痛较重时严重影响患者术后的生活质量和麻醉满意度。舒适化医疗使得术后咽喉痛得到了更多麻醉医生的关注,对于术后咽喉痛,其有效的预防及治疗成为今后麻醉领域的研究重点。进一步深入的了解术后咽喉痛的影响因素及治疗方法,能更好地使患者的疼痛减轻和提高术后的生活质量,加速患者的康复和缩短住院时间。本文旨在为减轻术后咽喉痛提供临床参考。
With the development of medical technology and the proposed concept of accelerated rehabilitation surgery, tracheal intubation with general anesthesia has become the primary anesthesia method for most operations. Postoperative sore throat is one of the complications after tracheal intubation with general anesthesia. When the pain is severe, it seriously affects patients’ postoperative quality of life and satisfaction with anesthesia. Comfort medicine has made postoperative sore throat more attractive to anesthesiologists, for postoperative throat pain, its effective prevention and treatment has become the focus of future anesthesia field research. Further in-depth understanding of post-operative throat pain influencing factors and treatment methods can better reduce the pain of pa-tients and improve postoperative quality of life, accelerate the recovery of patients and shorten the length of hospital stay. This article aims to provide clinical reference for relieving postoperative sore throat.
[1] | Chen, C.Y., Kuo, C.J., Lee, Y.W., et al. (2014) Benzydamine Hydrochloride on Postoperative Sore Throat: A Me-ta-Analysis of Randomized Controlled Trials. The Canadian Journal of Anesthesia, 61, 220-228.
https://doi.org/10.1007/s12630-013-0080-y |
[2] | Heike, K., Stephan, Z., Jan-Uwe, S., et al. (2006) Airway Injuries after One-Lung Ventilation: A Comparison between Double-Lumen Tube and Endobronchial Blocker: A Randomized, Prospective, Controlled Trial. Anesthesiology, 105, 471-477. https://doi.org/10.1097/00000542-200609000-00009 |
[3] | 彭艳, 嵇富海, 杨建平, 刘红. 应用不同材质气管导管对术后咽喉痛的影响[J]. 浙江临床医学, 2015(7): 1226, 1229. |
[4] | 叶爱素, 郑凤燕, 林卫红, 等. 早期雾化对患者双腔支气管插管术后咽喉痛的影响[J]. 实用医学杂志, 2016, 32(14): 2405-2407. |
[5] | 邹功胜, 杨军, 冯增光. 单肺通气中应用支气管封堵器与双腔支气管导管的比较[J]. 临床麻醉学杂志, 2012, 28(6): 557-559. |
[6] | 罗文. 喉罩气道和气管导管在腹腔镜盆腔包块切除术中的效果比较[J]. 实用中西医结合临床, 2019, 19(7): 122-123. |
[7] | Jaensson, M., Olowsson, L.L. and Nilsson, U. (2010) Endotracheal Tube Size and Sore Throat Follow-ing Surgery: A Randomized-Controlled Study. Acta Anaesthesiologica Scandinavica, 54, 147-153.
https://doi.org/10.1111/j.1399-6576.2009.02166.x |
[8] | Tosh, P., Kadapamannil, D., Rajan, S., Narayani, N. and Kumar, L. (2018) Effect of C-MAC Video Laryngoscope-Aided Intubations Using D-Blade on Incidence and Severity of Postoperative Sore Throat. Anesthesia, Essays and Researches, 12, 140-144. https://doi.org/10.4103/aer.AER_182_17 |
[9] | Ganason, N., Sivanaser, V., Liu, C.Y., et al. (2019) Post-Operative Sore Throat: 1) Comparing the Monitored Endotracheal Tube Cuff Pressure and Pilot 2) Balloon Palpation Methods. Malaysian Journal of Medical Sciences, 26, 132-138. https://doi.org/10.21315/mjms2019.26.5.12 |
[10] | Ansari, L., Bohluli, B., Mahaseni, H., et al. (2014) The Effect of Endotracheal Tube Cuff Pressure Control on Postextubation Throat Pain in Orthognathic Surgeries: A Randomized Double-Blind Controlled Clinical Trial. British Journal of Oral and Max-illofacial Surgery, 52, 140-143. https://doi.org/10.1016/j.bjoms.2013.10.005 |
[11] | 胡运连. 人工气道吸痰相关并发症发生的原因分析及对策探讨[J]. 检验医学与临床, 2011, 8(23): 2924-2925. |
[12] | 简晓敏, 刘焕仪, 曾彦茹, 等. 不同麻醉深度下全麻术后拔出气管导管时患者应激反应与舒适度的比较[J]. 广东医学, 2016, 37(12): 1900-1903. |
[13] | 张见岗, 杨磊, 刘洋. 视频喉镜气管插管对甲状腺手术后咽喉痛的影响[J]. 湖北民族大学学报(医学版), 2022, 39(1): 40-43. |
[14] | Yildirim, Z.B., Uzunkoy, A., Cigdem, A., et al. (2012) Changes in Cuff Pressure of Endotracheal Tube during Laparoscopic and Open Abdominal Surgery. Surgical Endoscopy, 26, 398-401. https://doi.org/10.1007/s00464-011-1886-8 |
[15] | 刘建辉, 张晓琴, 龚伟, 等. 控制气管插管套囊压力与术后并发症关系的多中心研究[J]. 麻醉与镇痛, 2013, 2(1): 74-78. |
[16] | 王宇霞, 夏欣华. 体位改变对人工气道机械通气患者气囊压力的影响[J]. 中国实用护理杂志, 2018, 34(9): 698-700. |
[17] | Higgins, P.P., Chung, F. and Mezei, G. (2002) Postoperative Sore Throat after Ambulatory Surgery. British Journal of Anaesthesia, 88, 582-584. |
[18] | Inoue, S., Abe, R., Tanaka, Y., et al. (2015) Tracheal Intubation by Trainees Does Not Alter the Incidence or Duration of Postoper-ative Sore Throat and Hoarseness: A Teaching Hospital Based Propensity Score Analysis. British Journal of Anaesthesia, 115, 463-469. |
[19] | 肖亚芬, 刘菊芳, 刘颖望, 等. 气管插管前静脉注射利多卡因对减少术后气道症状的效果观察[J]. 医学临床研究, 2010, 27(9): 1667-1669. |
[20] | 陶广华, 吴勇, 葛华顺, 等. 利多卡因雾化吸入对单肺通气患者围术期肺功能、炎症因子及相关并发症的影响[J]. 中国药房, 2021, 32(18): 2254-2259. |
[21] | 严文婵, 裴柳明. 麻醉恢复期气管内滴注利多卡因对甲状腺全麻术后拔管的疗效分析[J]. 饮食保健, 2021(34): 31-32. |
[22] | 高勇, 王秋红. 丁卡因联合酮咯酸氨丁三醇对气管插管后咽喉痛的影响[J]. 中国药物与临床, 2018, 18(8): 1390-1392. |
[23] | 张迎新, 李冠华, 隋波, 等. 罗哌卡因复合地塞米松气管内喷雾对患者耐管及术后咽喉痛的影响[J]. 中国医师进修杂志, 2014, 37(6): 26-29. |
[24] | 谭志林. 地塞米松对全麻患者术后声音嘶哑与咽喉痛的影响[J]. 黑龙江医药, 2020, 33(6): 1359-1361. |
[25] | 孙磊磊, 胡宝吉, 潘梦之, 等. 地塞米松对气管插管全麻患者术后声音嘶哑与咽喉痛的影响[J]. 浙江临床医学, 2017, 19(8): 1529-1530. |
[26] | 曲海霞, 李洁. 利多卡因联合布地奈德雾化吸入对双腔支气管插管患者术后咽喉痛的影响[J]. 中国药物与临床, 2020, 20(22): 3777-3779. |
[27] | 周俊妤, 代维. 帕瑞昔布钠预防腹腔镜胆囊切除术后咽喉痛疗效观察[J]. 检验医学与临床, 2021, 18(3): 368-371. |
[28] | 夏元华. 声带手术麻醉后咽喉痛采用氟比洛芬酯治疗的临床效果分析[J]. 中外医学研究, 2015(12): 40-41. |
[29] | 张辉, 邵东华, 吴进, 张维, 王华. 右美托咪定对全麻麻醉深度和术后咽喉痛的影响[J]. 江苏大学学报, 2015(5): 412-415. |
[30] | 郑北晨, 朱伶俐, 姜万维. 地塞米松复合右美托咪定对甲状腺术后咽喉痛的影响[J]. 世界最新医学信息文摘(连续型电子期刊), 2021, 21(15): 264-265. |
[31] | 常崇甫, 翁岚东, 郭培培, 等. 局部应用氯胺酮减少气管内插管术后咽喉痛的Meta分析[J]. 实用医学杂志, 2014(11): 1826-1829. |
[32] | Borazan, H., Kececioglu, A., Okesli, S., et al. (2012) Oral Magnesium Lozenge Reduces Postoperative Sore Throat: A Randomized, Prospective, Pla-cebo-Controlled Study. Anesthesiology, 117, 512-518. |
[33] | 王建英, 楼群兵, 朱伟生. 复方甘草片预防全身麻醉气管插管后咽喉痛和咳嗽的作用[J]. 现代实用医学, 2015, 27(6): 718-719. |
[34] | 靳永强, 张妮妮, 周文凤, 等. 最低剂量艾司氯胺酮联合右美托咪定对全麻术后患者复苏效果和咽喉痛的影响[J]. 中国当代医药, 2022, 29(10): 5-9. |