復(fù)方地塞米松預(yù)防氣管插管術(shù)后氣道并發(fā)癥的臨床研究

1、復(fù)方地塞米松預(yù)防氣管插管術(shù)后氣道并發(fā)癥的臨床研究復(fù)方地塞米松預(yù)防氣管插管術(shù)后氣道并發(fā)癥的臨床研究1郭海明龐志路孫政李佩涵韓雪萍＊鄭州大學(xué)第一附屬醫(yī)院麻醉科鄭州450052【摘要摘要】目的目的探討復(fù)方地塞米松軟膏對(duì)全麻插管術(shù)后氣道并發(fā)癥的預(yù)防作用。方法方法90例術(shù)前無(wú)任何呼吸道癥狀、無(wú)抽煙嗜好，ASA分級(jí)12級(jí)，擬在氣管插管全麻下行單側(cè)乳突根治術(shù)成人患者，隨機(jī)分為三組D組（復(fù)方地塞米松組，n=30）、L組（復(fù)方利多卡因乳膏組n=30）和S

2、組（石蠟油組n=30），在插管前氣管導(dǎo)管前端13分別均勻涂抹地塞米松軟膏2g、利多卡因軟膏2g和石蠟油。結(jié)果結(jié)果D組、L組與S組相比，術(shù)后氣道癥狀的發(fā)生率明顯降低（P0.01），D組與L組相比，咳嗽的發(fā)生率較低（P0.05），且S組的嚴(yán)重咳嗽，多痰發(fā)生率高于D組和L組（P0.01）。結(jié)論。結(jié)論復(fù)方地塞米松軟膏能有效預(yù)防和降低術(shù)后氣道并發(fā)癥。【關(guān)鍵詞關(guān)鍵詞】復(fù)方地塞米松乳膏；利多卡因乳膏；術(shù)后咽喉痛、咳嗽；氣管插管Theclinicalr

3、esearchofcompounddexamethasonegelappliedovertrachealtubetopreventpostoperativeairwaycomplicationsGuoHaimingPangZhiluSunZhengLiPeihanHanXuepingDepartmentofAnesthesiologytheFirstAffiliatedHospitalZhengzhouUniversityZhengzh

4、ou450052【Abstract】ObjectiveToevaluatetheeffectofcompounddexamethasonegelontheincidenceseverityofairwaysymptomsinducedbyotrachealintubation.MethodsNintyadultpatientswithoutrespiratysymptomssmokinghabitspreoperativelywerea

5、dopted.ThepatientshadASAclassⅠⅡlevelsweretreatedwithunilateraltympanoplastyundergeneralanesthesiarequiringotrachealintubation.Patientswereexpectedtoquicklyawakeafterthesurgery.Thepatientswereromlydividedintothreegroupsin

6、cludinggroupDgroupLthegroupSwhichweretreatedwithcompounddexamethasonegellidocainegelliquidparaffinrespectively.Theincidenceseverityofpostoperativerespiratysymptomswereevaluated.ResultsTheincidenceseverityofpostoperativea

7、irwaycomplicationsareloweringroupDgroupLcomparedwithgroupS(P0.01)TheincidenceofcoughingroupDislowerthanthatofgroupL(P0.05)theserious1＊通訊作者：韓雪萍鄭州大學(xué)第一附屬醫(yī)院麻醉科鄭州市建設(shè)東路1號(hào)450052Email：hanxueping666@達(dá)唑侖0.05mgkg芬太尼(46)gkg順式阿曲庫(kù)銨1.5

8、mgkg依托咪酯2mgkg術(shù)中維持用藥丙泊酚（得普利麻）46mg(kg?h)瑞芬太尼（宜昌制藥）0.10.2g(kg?min)術(shù)中維持生命體征平穩(wěn)，根據(jù)需要使用活血管藥物對(duì)癥處理。所有插管操作和術(shù)后評(píng)估采用雙盲法，隨訪者于拔管術(shù)后24h評(píng)估患者的氣道癥狀（包括咽喉痛、咳嗽、多痰）的分級(jí)情況，評(píng)分細(xì)則如表1[6].表1.咽喉痛、咳嗽、多痰分級(jí)量表分級(jí)咽喉痛0手術(shù)后無(wú)任何咽喉痛1輕微咽喉痛2中等咽喉痛3嚴(yán)重咽喉痛咳嗽0手術(shù)后無(wú)咳嗽1輕微咳嗽