陳語霖 張軍橋 張雷

【摘要】目的 觀察地塞米松聯(lián)合利多卡因噴喉對(duì)婦科腔鏡手術(shù)氣管插管后咽喉并發(fā)癥的療效。

方法 120例婦科腹腔鏡手術(shù)患者隨機(jī)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(dǎo)后喉鏡暴露聲門，3組用相應(yīng)藥液噴灑會(huì)厭和氣管內(nèi)。觀察術(shù)后1 h、6 h和24 h咽喉痛、咳嗽和聲音嘶啞的發(fā)生情況；采集術(shù)前24 h和術(shù)后24 h音樣，分析每組兩個(gè)時(shí)刻的基頻微擾值（Jitter）和基頻（F0）。結(jié)果 術(shù)后1 h、6 h，S組咽喉痛、咳嗽和聲音嘶啞的發(fā)生率及四分制評(píng)分均高于DL組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），術(shù)后24 h，S組咽喉痛發(fā)生率和評(píng)分也高于

DL組；差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。術(shù)后6 h，LS組咽喉痛和咳嗽的發(fā)生率及評(píng)分均高于DL組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。術(shù)后24 h，S組的基頻微擾值高于DL組和LS組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），每組術(shù)后24 h基頻微擾和基頻均高于術(shù)前24 h，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 地塞米松與利多卡因聯(lián)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(fā)癥的發(fā)生率，效果優(yōu)于單一用藥。

【關(guān)鍵詞】地塞米松；利多卡因；氣管插管；咽喉痛；術(shù)后并發(fā)癥

【中圖分類號(hào)】R762 【文獻(xiàn)標(biāo)識(shí)碼】A 【文章編號(hào)】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