摘要
目的探讨老年患者心脏手术中经食道超声心动图检查（TEE）后吞咽痛的影响因素。方法将2010年11月至2012年8月我院96例心脏手术中经食道超声心动图检查的患者分为两组，其中≥65岁组60例，〈65岁组36例．收集患者的临床资料并随访，使用疼痛数字等级定量表评估术后吞咽痛。比较两组患者术后吞咽痛的特点，并运用Logistic回归分析方法探讨老年患者心脏手术后吞咽痛的影响因素。结果与〈65岁组相比，≥65岁组术后吞咽痛发生率高（88．3％对66．7％，P〈O．025）、疼痛评分高（2．6土1．7）分和（1．4±0．9）分（P〈0．01）。Logistic回归分析显示，会麻前I：1服利多卡因胶浆、VI咽黏膜损伤、TEE留置时间是老年患者术后吞咽痛的影响因素（P〈0．01）。结论老年患者心脏手术中TEE后吞咽痛发生率高，疼痛程度重。应在全麻前口服利多骨因胶浆，减少口咽黏膜损伤，缩短TEE留置时间以缓解患者术后吞咽痛。
Objective To evaluate the influencing factors for postoperative odynophagia in elderly patients undergoing intraoperative transesophageal echocardiography （TEE） examination for cardiac surgery. Methods A total of 96 patients with intraoperative TEE examination for cardiac surgery was divided into two groups： the elderly group （patients aged ~65 years, n：60） and the young group （patients aged ~ 65 years, n = 36）. Clinical data were retrospectively analyzed. Postoperative odynophagia was assessed by number rating scale （NRS） scores. Characteristics of postoperative odynophagia were compared between the two groups. Influencing factors for postoperative odynophagia were analyzed by multivariable logistic regression analysis. Results The incidence of postoperative odynophagia and the average NRS score were higher in the elderly group thaninthe young group [88.3~ vs. 66.7~, （2.6~1.7） vs. （1.4＋_0.9）, P^0.05 or 0.01]. Multivariate logistic regression analysis showed that preoperative oral lidocaine plasmagel, oropharyngeal mucosal injury and duration of TEE insertion were independent influencing factors for postoperative odynophagia （all P^0.01）. Conclusions The incidence of postoperative odynophagia is higher and the degree of odynophagia is more serious in elderly patients undergoing intraoperative FEE examination for cardiac surgery. Postoperative odynophagia can he relieved by applying the preoperative oral lidocaine plasmagel, reducing oropbaryngeal mucosal injury and shortening the duration of TEE insertion.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2013年第10期1098-1100,共3页
Chinese Journal of Geriatrics
