气管内局部应用丁胺卡那霉素对气管插管后患者咽喉痛的影响

林应川 马雪松 贾佳 栾海星

【摘要】 目的：觀察注药式气管导管注药套囊内注入丁胺卡那霉素是否能降低插管后咽喉痛发生率及减轻疼痛程度。方法：选择全麻下行气管插管的女性患者90例作为研究对象，ASA分级Ⅰ、Ⅱ级，采用随机数字表法分为丁胺卡那霉素不同剂量组[A组（n=30），B组（n=30）]和生理盐水组（NS组，n=30）。所有患者均使用7.0 mm内径的注药式气管导管，在气管插管前对气管导管进行处理。A组注药套囊内注入丁胺卡那霉素溶液3 mL（20 mg/mL），B组注药套囊内注入丁胺卡那霉素溶液3 mL（40 mg/mL），NS组注药套囊内注入0.9%氯化钠溶液3 mL。比较三组手术类型、术中地佐辛和氟比洛芬酯用量、拔管后1、6、24 h咽喉痛发生情况及疼痛程度。结果：与NS组比较，A组拔管后1、6 h咽喉痛发生率均明显降低，且疼痛严重程度均减轻，差异均有统计学意义（P<0.016 7）;与NS组比较，B组拔管后6 h咽喉痛发生率降低，且疼痛严重程度减轻，差异均有统计学意义（P<0.016 7）。结论：注药式气管导管注药套囊内注入丁胺卡那霉素，可降低气管插管后咽喉痛发生率，同时减轻疼痛严重程度。

【关键词】 气管插管 注药式气管导管 丁胺卡那霉素 咽喉痛

Effect of Local Application of Amikacin on Pharyngeal Pain after Endotracheal Intubation/LIN Yingchuan， MA Xuesong， JIA Jia， LUAN Haixing. //Medical Innovation of China， 2021， 18（27）： -144

[Abstract] Objective： To observe whether Amikacin injected into the capsule of medicine injection endotracheal tube can reduce the incidence and degree of pharyngeal pain after intubation. Method： Ninety female patients with endotracheal intubation under general anesthesia were selected as the research objects， ASA grade Ⅰ and Ⅱ， the patients were randomly divided into Amikacin different dose groups [group A （n=30）， group B （n=30）] and normal saline group （NS group， n=30）. Patients received 7.0 mm inner diameter endotracheal tubes with injecting medicine， the endotracheal tube was treated before endotracheal intubation. In group A， 3 mL Amikacin （20 mg/mL） was injected in injection cuff. In group B， 3 mL Amikacin （40 mg/mL） was injected in injection cuff. In NS group， 3 mL of 0.9% sodium chloride solution was injected into the drug sleeve capsule. The type of operation， the dosage of Dizocine and Flurbiprofen axetil during operation， the occurrence and degree of throat pain at 1， 6 and 24 h after extubation were compared. Result： Compared with NS group， the incidence of pharyngeal pain at 1 and 6 h after extubation of group A were significantly reduced， and the severity of pain were reduced， the differences were statistically significant （P<0.016 7）. Compared with NS group， the incidence of pharyngeal pain at 6 h after extubation of group B was significantly reduced， and the severity of pain was reduced， the differences were statistically significant （P<0.016 7）. Conclusion： Amikacin can effectively reduce the incidence rate and severity of post-intubation sore throat.

[Key words] Endotracheal intubation Endotracheal tube with injecting medicine Amikacin Pharyngeal pain

First-author’s address： The First Affiliated Hospital of Xiamen University， Xiamen 361000， China

doi：10.3969/j.issn.1674-4985.2021.27.035

气管内插管是迅速、安全、简单的气道管理方法之一。气管内插管可能会造成咽喉部黏膜损伤引起咽喉部黏膜充血、水肿，产生无菌性炎症，导致咽喉痛的发生。另外，口咽部细菌沿气管导管外壁进入声门下气道，入侵损伤的黏膜，可能会促进炎症反应[1]。导管套囊上与声门下集聚口咽部分泌物，易成为下呼吸道感染的细菌库（图1）。……