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第44卷第8期 刘 超,吉 林,刘存明. 腹腔镜结直肠手术中气管导管套囊压力控制对术中血流动力学及术后
2024年8月 咽喉痛的影响[J]. 南京医科大学学报(自然科学版),2024,44(8):1100-1105 ·1103 ·
表1 两组患者术前基本情况及手术相关信息
Table 1 Preoperative characteristics and surgical information of patients in the two groups
Parameter Group H(n=48) Group L(n=46) P
Age(years,x ± s) 70.6 ± 6.4 68.9 ± 7.3 0.224
Sex[n(%)] 0.414
Male 27(56.3) 22(47.8)
Female 21(43.8) 24(52.2)
Height(cm,x ± s) 165.5 ± 7.20 164.7 ± 6.90 0.552
Weight(kg,x ± s) 64.5 ± 9.3 67.3 ± 7.9 0.127
ASA classification[n(%)] 0.724
Ⅰ 19(39.6) 16(34.8)
Ⅱ 18(37.5) 21(45.7)
Ⅲ 11(22.9) 09(19.6)
The first life sign
Heart rate(beats/min,x ± s) 64.0 ± 6.5 66.1 ± 7.9 0.173
Systole pressure(mmHg,x ± s) 131.2 ± 13.1 131.0 ± 10.1 0.925
Diastolic pressure(mmHg,x ± s) 076.9 ± 10.1 79.0 ± 7.8 0.276
Preoperative complications[n(%)]
Hypertension 13(27.0) 17(37.0) 0.305
Coronary heart disease 15(31.3) 18(39.1) 0.424
Diabetes 07(14.6) 10(21.7) 0.368
Tracheal intubation time(s,x ± s) 39.6 ± 5.4 37.2 ± 7.1 0.074
Adverse reaction[n(%)]
Restlessness 06(12.5) 05(10.9) 0.806
Nausea and vomiting 07(14.6) 09(19.6) 0.521
Strong cough 08(16.7) 05(10.9) 0.416
Surgery time(min,x ± s) 124.6 ± 16.2 126.5 ± 17.3 0.577
Anesthesia time(min,x ± s) 153.1 ± 17.8 154.8 ± 17.9 0.646
Blood loss(mL,x ± s) 162.2 ± 37.2 169.6 ± 38.8 0.345
The volume(mL,x ± s) 1 230.1 ± 122.8 1 253.7 ± 108.2 0.342
表2 两组患者不同时间点套囊压力和气道压力比较
Table 2 Comparisons of cuff pressure and airway pressure at different time points of patients in the two groups
(cmH2O,x ± s)
Time point
Indicator Group
T1 T2 T3 T4 T5
Cuff pressure H(n=48) 26.8 ± 0.7 26.5 ± 1.3 28.0 ± 0.8 a 29.3 ± 0.8 ab 27.0 ± 0.9 bc
L(n=46) 47.4 ± 2.7 * 47.7 ± 2.6 * 50.1 ± 2.8 a* 53.1 ± 2.8 ab* 49.3 ± 3.3 b*
Airway pressure H(n=48) 13.9 ± 1.7 13.6 ± 1.8 17.9 ± 1.8 a 22.0 ± 2.4 ab 14.3 ± 1.7 c
L(n=46) 13.4 ± 1.8 13.7 ± 1.7 17.2 ± 1.9 a 22.0 ± 2.8 ab 14.0 ± 1.7 c
b
*
c
a
Compared with T1,P < 0.05;compared with T3,P < 0.05;compared with T4,P < 0.05;compared with the group H at the same time point,P <
0.05.
生影响。研究人员发现当气管导管套囊压力超过 压套囊在损伤气管黏膜的同时,还可以刺激患者气
30 cmH2O 时,气管黏膜的毛细血管受压,毛细血管 管局部,引起躯体应激反应,导致交感⁃肾上腺髓质
血流量减少,从而造成黏膜损伤,出现气管壁缺血、 系统兴奋性升高,表现出HR增快、血压升高等生命
溃疡、术后发音困难、咳嗽、气管坏死、气管破裂、喉 体征的变化 。
[13]
气管狭窄和神经麻痹、气管食管瘘等并发症 [12] 。高 本研究显示,在套囊压力控制下,H组患者术后