【摘要】 目的 探讨持续控制气管导管套囊压力对腹腔镜子宫切除患者术后气道不适症状的影响。方法 纳入全麻下行腹腔镜子宫切除术患者60例，按随机数字法分为A、B两组各30例，A组气管插管成功后使用换能器持续监测套囊压力但不进行套囊压力控制；B组使用换能器持续监测并始终调整套囊压力维持在25～30 cmH₂O。记录两组患者插管时（T_a）、气腹建立时（T_b）、头低位时（T_c）、气腹结束时（T_d）、拔管时（T_e）气管导管套囊压力；采用VAS评分评估术后拔管时（T₁）、术后2 h （T₂）、术后1 d （T₃）、术后3 d （T₄）咽痛程度；拔管时纤支镜观察套囊处黏膜情况；收集术后24 h内第1次痰液，记录痰隐血阳性例数。结果 与A组比较，B组T_b-e时点套囊压力较低；T₂时点咽痛程度较轻；拔管时纤支镜观察气道黏膜损伤面膜点状充血、片状充血、黏膜破损和溃疡发生例数较少，痰隐血阳性例数较少（P<0.05）。结论 术中持续套囊压力控制有助于降低腹腔镜子宫切除术患者气道不适。更多还原

【Abstract】 Objective To investigate the impact of continuous endotracheal tube cuff pressure control on postoperative airway discomfort in patients undergoing laparoscopic hysterectomy under general anesthesia.Methods Sixty patients receiving general anesthesia for laparoscopic hysterectomy were selected. The patients were divided into group A and group B by using random number table method, 30 in each group, The group A continuously monitored cuff pressure using a transducer without active control. The group B also used a transducer to monitor and actively adjust the cuff pressure to maintain it between 25～30 cmH₂O. The cuff pressures were recorded at times of intubation（T_a）, establishment of pneumoperitoneum（T_b）, head-down position（T_c）, end of pneumoperitoneum（T_d） and extubation（T_e）. Postoperative airway discomfort was assessed at several intervals using the Visual Analog Scale（VAS） at immediately post-extubation（T₁）, 2 hours post-operation（T₂）, 1 day post-operation（T₃） and 3 days post-operation（T₄）. Bronchoscopic examination was performed during extubation to observe mucosal conditions, and the presence of occult blood in sputum was noted within the first 24 h post-operation.Results Compared with the group A, the group B had lower cuff pressure at T_b-e. Pharyngeal pain in the group B at T2 was milder than the group A. During extubation, bronchoscopic observation of airway mucosal injury showed fewer cases of facial mask punctate congestion, lamellar congestion, mucosal damage and ulceration in the group B than those in the group A. The number of cases of sputum occult blood positive in the group B was fewer than that in the group A（P<0.05）.Conclusions Active control of tracheal cuff pressure during surgery can significantly reduce postoperative airway discomfort in patients undergoing laparoscopic hysterectomy.更多还原