地塞米松對氣管插管患者術后咽喉并發癥的影響

陳語霖 張軍橋 張雷

【摘要】目的 觀察地塞米松聯合利多卡因噴喉對婦科腔鏡手術氣管插管后咽喉并發癥的療效。

方法 120例婦科腹腔鏡手術患者隨機分為3組，地塞米松5 mg+2%利多卡因3 mL組（DL組）、2%利多卡因

3 mL+生理鹽水1 mL組（LS組）和生理鹽水4 mL組（S組），麻醉誘導后喉鏡暴露聲門，3組用相應藥液噴灑會厭和氣管內。觀察術后1 h、6 h和24 h咽喉痛、咳嗽和聲音嘶啞的發生情況；采集術前24 h和術后24 h音樣，分析每組兩個時刻的基頻微擾值（Jitter）和基頻（F0）。結果 術后1 h、6 h，S組咽喉痛、咳嗽和聲音嘶啞的發生率及四分制評分均高于DL組，差異有統計學意義（P<0.05），術后24 h，S組咽喉痛發生率和評分也高于

DL組；差異有統計學意義（P<0.05）。術后6 h，LS組咽喉痛和咳嗽的發生率及評分均高于DL組，差異有統計學意義（P<0.05）。術后24 h，S組的基頻微擾值高于DL組和LS組，差異有統計學意義（P<0.05），每組術后24 h基頻微擾和基頻均高于術前24 h，差異有統計學意義（P<0.05）。結論 地塞米松與利多卡因聯合噴喉通過抗炎、減輕水腫和局部麻醉作用，可以有效減少氣管插管后咽喉并發癥的發生率，效果優于單一用藥。

【關鍵詞】地塞米松；利多卡因；氣管插管；咽喉痛；術后并發癥

【中圖分類號】R762 【文獻標識碼】A 【文章編號】ISSN.2095-6681.2019.10..03

The Effects of Dexamethasone in postoperative throat complications with endotracheal intubation

CHEN Yu-lin1，ZHANG Jun-qiao2，ZHANG Lei2，JI Guo-li1，ZHANG Yan2

（1.Department of Anesthesiology，Weifang Medical College，Shandong Weifang 261053，China；

2.Affiliated Hospital of Weifang Medical College，Shandong Weifang 261031，China）

【Abstract】Objective To observe the efficacy of dexamethasone combined with lidocaine in the tr-eatment of postoperative throat complications after endotracheal intubation in patients with gynec-ological laparoscopy.Methods 120 patients were randomly divided into 3 groups.Dexamethasone 5mg +2%lidocaine 3ml group （DL group），2% lidocaine 3ml +saline 1ml group （LS group），physiological sal-ine 4ml group （S group），Laryngoscope exposure to glottis after anesthesia induction， 3 groups weresprayed epiglottis and tubules with corresponding liquid.The incidence and severity of sore throa-t，cough and hoarseness were observed at 1h，6h and 24h after operation，and the baseline Jitter and F0 were analyzed and extracted at 24 hours before and 24 hours after operation.Results The incide-nce and score of sore throat，cough and hoarseness in group S were higher than those in group DL （P<0.05），and the incidence and score of sore throat in group S were higher than those in group DL at 24 h after operation （P<0.05）.The incidence and score of sore throat and cough in LS group were higher than those in DL group 6 hour after operation （P<0.05）.At 24 hours after operation，the Jitter of group S was higher than that of group LS and DL （P<0.05），and each group of 24h after Ji-tter and F0 are higher than that of preoperative 24h （P<0.05）.Conclusion The combination of dex-amethasone and lidocaine can effectively reduce the incidence of postoperative throat complicationsafter tracheal intubation