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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
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