护理干预套囊压力联合雾化吸入对继发甲状旁腺功能亢进手术病人术后咽喉部并发症效果观察

目的观察护理干预套囊压力联合雾化吸入对改善继发甲状旁腺功能亢进（甲旁亢）手术病人术后咽喉部不适的疗效。方法将90例继发甲旁亢病人随机分为A、B、C 3组，各30例。其中A组病人给予全身麻醉，术后病人清醒拔管后立即入麻醉恢复室（PACU）行PACU常规护理；B、C组术中麻醉、插管方式与A组相同，气囊充气外接套囊压力表动态调整套囊压力，压力维持在25~30 cmH₂O，B组病人术后清醒拔管后入PACU行PACU常规护理；C组术后清醒拔管后入PACU立即予布地奈德2 mg+0.9%氯化钠溶液5 mL雾化吸入。分别记录3组病人拔管后入PACU（T₁）、出PACU（T₂）、术后6 h（T₃）、术后24 h（T₄）咽痛、咽干、恶心呕吐、声嘶发生率和严重程度，并询问病人满意度，横向对比2种护理方式对病人全麻气管插管后咽喉部并发症的干预效果。结果T₁时C组咽痛评分低于A、B组（P < 0.01），咽干评分3组差异无统计学意义（P>0.05）；T₂、T₃和T₄时，咽痛和咽干评分均C组 < B组 < A组（P < 0.01）；C组满意度优于B组和A组（P < 0.05），A组和B组差异无统计学意义（P>0.05）。结论护理干预套囊压力联合雾化吸入可减轻术后病人咽痛、咽干程度，加速病人术后恢复，提高病人的满意度。

Effect of nursing intervention cuff pressure combined with nebulized inhalation on postoperative throat complications in patients with secondary hyperparathyroidism

ObjectiveTo observe the effects of nursing intervention cuff pressure combined with nebulized inhalation on improving postoperative throat discomfort in patients with secondary hyperparathyroidism.MethodsNinety patients with secondary hyperparathyroidism were randomly divided into the A, B and C groups(30 cases each group).The group A received general anesthesia, and was admitted to the post-anaesthesia monitoring room (PACU) for routine PACU care immediately after awake extubation.The anesthesia and intubation in group B and group C were the same as the group A, the cuff pressure was dynamically adjusted using external jacket pressure gauge, and maintained at 25~30 cmH₂O, group B was admitted to the PACU for routine PAUC care after awake extubation, and the group C was treated with aerosol inhalation of 2 mg budesonide and 5 mL 0.9% sodium chloride solution after awake extubation.The incidence rates and severity of sore throat, dry throat, nausea vomiting and hoarseness in three groups at entering into PACU after extubation(T₁), coming out of PACU(T₂), postoperative 6 h(T₃) and postoperative 24 h(T₄) were recorded.The satisfaction of patients was also inquired, and the effects of two nursing methods on the intervention of throat after the general anesthesia were laterally compared.ResultsAt T₁, the sore throat score in C group was lower than that in group A and group B (P < 0.01), and the differences of pharyngeal dryness score among three groups were not statistically significant(P < 0.01).At T₂, T₃ and T₄, the scores of sore throat and pharyngeal dryness in group C, group B and group A gradually increased in turn(P < 0.01).The satisfaction in group C was better than that in group B and group A(P < 0.05), and the difference of which between group A and group B was not statistically significant(P>0.05).ConclusionThe nursing intervention cuff pressure combined with atomization inhalation can reduce the postoperative sore throat and pharyngeal dryness, accelerate postoperative recovery of and improve the satisfaction of patients.