气管导管套囊压力控制对老年食管癌患者围手术期咽喉痛及肺部并发症的影响

Effect of endotracheal tube cuff pressure on perioperative sore throat and pulmonary complications in elderly patients with esophageal cancer

摘要:

目的 探究气管导管套囊压力控制对老年食管癌患者围手术期咽喉痛及肺部并发症的影响。方法 选取2022年2月—2023年2月盐城市第三人民医院收治的食管癌患者84例，均行胸腔镜食管癌根治手术，将患者随机分为套囊压力控制组（实验组）与非导管套囊压力控制组（对照组），每组42例。比较两组麻醉时间、手术时间、气管插管后的套囊压力、术中出血量，以及咽喉痛、咽喉干、发声困难、吞咽困难等咽部相关并发症发生情况；比较两组术后1、24 h咽喉痛视觉模拟评分（VAS）；比较两组患者出手术室前15、10和5 min的血氧饱和度（SpO₂）；比较两组术后7 d的肺部并发症发生情况及严重程度。结果 对照组套囊压力高于实验组（P <0.05）。对照组咽喉痛、咽喉干发生率均高于实验组（P <0.05）。对照组术后1和24 h咽喉痛VAS评分均高于实验组（P <0.05）。实验组与对照组出手术室前15、10和5 min的SpO₂比较，结果 ①不同时间点SpO₂比较，差异有统计学意义（P <0.05）；②实验组与对照组SpO₂比较，差异有统计学意义（P <0.05），实验组SpO₂高于对照组；③两组SpO₂变化趋势比较，差异无统计学意义（P >0.05）。对照组肺部并发症发生率较高（P <0.05），分级情况较差（P <0.05）。结论 胸腔镜食管癌根治手术中气管导管套囊压力控制有助于减轻患者术后咽喉痛，并减少肺部并发症。

Abstract:

Objective To investigate the effects of endotracheal tube cuff pressure on perioperative sore throat and pulmonary complications in elderly patients with esophageal cancer.Methods From February 2022 to February 2023, a total of 84 esophageal cancer patients who were admitted to Yancheng Third People's Hospital and underwent thoracoscopic radical surgery for esophageal cancer were selected. They were divided into the cuff pressure-controlled group (experimental group) and the cuff pressure-uncontrolled group (control group), with 42 cases in each group. The duration of anesthesia and surgery, endotracheal tube cuff pressure, intraoperative blood loss, and incidences of pharyngeal complications including sore throat, dry throat, dysphonia and dysphagia were compared between the two groups. The Visual Analogue Scale (VAS) scores 1 h and 24 h after the surgery were compared between the two groups. The arterial oxygen saturation (SaO₂) 15 min, 10 min and 5 min before the patients came out of the operating room were compared between the two groups. The incidence and severity of pulmonary complications (including cough, atelectasis, pneumonia, pleural effusion, pneumothorax and suspected pneumonia) were compared between the two groups.Results The endotracheal tube cuff pressure in the control group was higher than that in the experimental group (P < 0.05). The incidences of sore throat and dry throat in the control group were significantly higher than those in the experimental group (P < 0.05). The VAS scores for the sore throat 1 h and 24 h after surgery in the control group were significantly higher than those in the experimental group (P < 0.05). The comparison of SpO₂ 15 min, 10 min, and 5 min before the patients came out of the operating room in the experimental group and the control group showed that there were differences in SpO₂ at different time points (P < 0.05) and between the two groups (P < 0.05), and that the SpO₂ in the experimental group was significantly higher than that in the control group. There was no statistically significant difference in the change trend of SpO₂ between the two groups (P > 0.05). The incidence and grading of pulmonary complications in the control group were significantly higher than those in the experimental group (P < 0.05).Conclusion The control of the endotracheal tube cuff pressure during thoracoscopic radical surgery for esophageal cancer is beneficial in reducing postoperative sore throat and pulmonary complications.