气管插管袖带放气法可降低妇科腹腔镜手术患者的应激反应和术后咽部并发症的发生率。

IF 0.9 4区 医学 Q3 SURGERY Annali italiani di chirurgia Pub Date : 2024-01-01 DOI:10.62713/aic.3689
Yan Li, Jing Sun, Kaidi Cui, Jingjing Li, Lei Cai
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引用次数: 0

摘要

目的:本研究旨在探讨气管导管充气罩囊放气方式对妇科腹腔镜手术患者拔管应激反应及术后咽部并发症的影响:本研究收集并分析了2023年6月至2024年6月在西北妇女儿童医院接受全身麻醉下妇科腹腔镜手术治疗的94例患者的回顾性临床资料。根据麻醉后使用的袖带放气方法将患者分为两组:A 组(45 名患者)采用一次性放气法,B 组(49 名患者)采用逐渐放气法。记录手术相关指标,并在选定的时间点监测心率(HR)、平均动脉压(MAP)、速率压力乘积(RPP)、肾上腺素(E)、去甲肾上腺素(NE)和皮质醇(Cor)水平:袖带前(T0)、拔管后立即(T1)、拔管后 1 分钟(T2)、拔管后 5 分钟(T3)和拔管后 10 分钟(T4)。两组咽部并发症的发生率也进行了比较:与 A 组相比,B 组在 T1、T2 和 T3 的 HR、MAP 和 RPP 变化较小(P < 0.05)。与 A 组相比,B 组在 T2、T3 和 T4 阶段的 E、NE 和 Cor 水平变化也较小(P < 0.05)。与 A 组相比,B 组咳嗽、咽痛和声音嘶哑等并发症的发生率明显降低(6.12% vs 22.22%,P < 0.05):结论:对接受妇科腹腔镜手术治疗的患者而言,气管导管袖带逐渐放气可显著改善拔管应激反应,稳定血流动力学,减轻咽部不适。
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Endotracheal Tube Cuff Deflation Methods Reduce Stress Response and Incidence of Postoperative Pharyngeal Complications in Patients Treated with Gynecological Laparoscopic Surgery.

Aim: This study aims to explore the impact of endotracheal tube cuff deflation methods on extubation stress responses and postoperative pharyngeal complications in patients treated with gynecological laparoscopic surgery.

Methods: In this study, retrospective clinical data of 94 patients treated with gynecological laparoscopic surgery under general anesthesia in Northwest Women's and Children's Hospital from June 2023 to June 2024 were collected and analyzed. Patients were assigned into two groups based on the cuff deflation methods used after anesthesia: Group A (45 patients) adopted a one-time deflation method, while Group B (49 patients) employed a gradual deflation method. Surgery-associated indicators were recorded, with heart rate (HR), mean arterial pressure (MAP), rate pressure product (RPP), epinephrine (E), norepinephrine (NE), and cortisol (Cor) levels monitored at selected time points: before cuff (T0), immediately after extubation (T1), 1 minute post-extubation (T2), 5 minutes post-extubation (T3), and 10 minutes post-extubation (T4). The incidence of pharyngeal complications was also compared between the two groups.

Results: Compared with Group A, Group B displayed smaller variations in HR, MAP, and RPP at T1, T2, and T3 (p < 0.05). Group B also showed smaller variations in E, NE, and Cor levels at T2, T3, and T4 in contrast with Group A (p < 0.05). The incidence of complications such as coughing, sore throat, and hoarseness was conspicuously attenuated in Group B compared to Group A (6.12% vs 22.22%, p < 0.05).

Conclusions: Gradual deflation of the endotracheal tube cuff dramatically ameliorates extubation stress responses, stabilizes hemodynamics, and alleviates pharyngeal discomfort in patients treated with gynecological laparoscopic surgery.

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来源期刊
CiteScore
0.90
自引率
12.50%
发文量
116
审稿时长
>12 weeks
期刊介绍: Annali Italiani di Chirurgia is a bimonthly journal and covers all aspects of surgery:elective, emergency and experimental surgery, as well as problems involving technology, teaching, organization and forensic medicine. The articles are published in Italian or English, though English is preferred because it facilitates the international diffusion of the journal (v.Guidelines for Authors and Norme per gli Autori). The articles published are divided into three main sections:editorials, original articles, and case reports and innovations.
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