陈语霖 张军桥 张雷
【摘要】目的 觀察地塞米松联合利多卡因喷喉对妇科腔镜手术气管插管后咽喉并发症的疗效。
方法 120例妇科腹腔镜手术患者随机分为3组，地塞米松5 mg+2%利多卡因3 mL组（DL组）、2%利多卡因
3 mL+生理盐水1 mL组（LS组）和生理盐水4 mL组（S组），麻醉诱导后喉镜暴露声门，3组用相应药液喷洒会厌和气管内。观察术后1 h、6 h和24 h咽喉痛、咳嗽和声音嘶哑的发生情况；采集术前24 h和术后24 h音样，分析每组两个时刻的基频微扰值（Jitter）和基频（F0）。结果 术后1 h、6 h，S组咽喉痛、咳嗽和声音嘶哑的发生率及四分制评分均高于DL组，差异有统计学意义（P<0.05），术后24 h，S组咽喉痛发生率和评分也高于
DL组；差异有统计学意义（P<0.05）。术后6 h，LS组咽喉痛和咳嗽的发生率及评分均高于DL组，差异有统计学意义（P<0.05）。术后24 h，S组的基频微扰值高于DL组和LS组，差异有统计学意义（P<0.05），每组术后24 h基频微扰和基频均高于术前24 h，差异有统计学意义（P<0.05）。结论 地塞米松与利多卡因联合喷喉通过抗炎、减轻水肿和局部麻醉作用，可以有效减少气管插管后咽喉并发症的发生率，效果优于单一用药。
【关键词】地塞米松；利多卡因；气管插管；咽喉痛；术后并发症
【中图分类号】R762 【文献标识码】A 【文章编号】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
