南方医科大学学报

南方医科大学学报 ›› 2025, Vol. 45 ›› Issue (11): 2511-2517.doi: 10.12122/j.issn.1673-4254.2025.11.24

• • 上一篇    

全身麻醉下甲状腺切除术中应用神经监测气管导管会增加术后咽喉痛的发生风险：一项回顾性队列研究

陈丽红1,2(), 陈雅芬1,2(), 谢惠琳1,2, 黄彦诚1,2, 黄雅彬1,2, 靳三庆1,2()   

  1. 1.中山大学附属第六医院麻醉科，广东 广州 510655
    2.广州市黄埔区中六生物医学创新研究院，广东 广州 510799
  • 收稿日期:2025-08-10 出版日期:2025-11-20 发布日期:2025-11-28
  • 通讯作者: 靳三庆 E-mail:chenlihn@mail.sysu.edu.cn;chenyf399@mail.sysu.edu.cn;jinsq@mail.sysu.edu.cn
  • 作者简介:陈丽红，博士，主治医师，E-mail: chenlihn@mail.sysu.edu.cn
    陈雅芬，硕士，住院医师，E-mail: chenyf399@mail.sysu.edu.cn
    第一联系人：共同第一作者
  • 基金资助:
    广东省医学科学技术研究基金项目(A2022002)

Intubaiton with electromyographic endotracheal tube increases risks of postoperative sore throat following thyroidectomy under general anesthesia: a retrospective cohort study

Lihong CHEN1,2(), Yafen CHEN1,2(), Huilin XIE1,2, Yancheng HUANG1,2, Yabin HUANG1,2, Sanqing JIN1,2()   

  1. 1.Department of Anesthesiology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, China
    2.Biomedical Innovation Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510799, China
  • Received:2025-08-10 Online:2025-11-20 Published:2025-11-28
  • Contact: Sanqing JIN E-mail:chenlihn@mail.sysu.edu.cn;chenyf399@mail.sysu.edu.cn;jinsq@mail.sysu.edu.cn

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摘要：

目的 探讨神经监测气管导管（EMG导管）与普通钢丝加强型气管导管（CWR导管）对全身麻醉下行甲状腺手术患者术后咽喉痛（POST）发生率的影响，并分析其相关危险因素。 方法 本研究为回顾性队列研究，收集2024年10月~2025年3月于中山大学附属第六医院接受择期甲状腺手术的245例全麻患者的临床资料，根据术中所用气管导管类型，将患者分为EMG组（n=100）和CWR组（n=145），比较两组POST及其他并发症的发生情况。为控制潜在混杂因素，采用倾向性评分匹配（PSM）方法对两组进行基线特征调整，匹配后进一步采用多因素Logistic回归分析，筛选影响POST发生的独立危险因素。 结果 初步基线资料比较显示，EMG组与CWR组在部分变量上存在统计学差异（P<0.05），经PSM匹配后共纳入165例患者（EMG组90例，CWR组75例），两组基线特征差异均无统计学意义（P>0.05），具有可比性。匹配后分析结果显示，EMG组手术时长较CWR组缩短（P=0.002），但POST发生率升高（P=0.001）。多因素Logistic回归分析结果显示，术中使用EMG导管（OR=17.50，95% CI： 2.25~136.03，P<0.01）是POST发生的独立危险因素。 结论 EMG导管在甲状腺手术中有助于缩短手术时间并实现喉返神经功能保护，但其特殊结构可能增加术后咽喉痛的发生风险。临床应用中应权衡神经保护与患者术后舒适度，合理选择导管类型及优化插管策略，以提升患者围术期体验。

关键词: 神经监测气管导管, 术后咽喉痛, 甲状腺手术, 气管插管, 回顾性研究

Abstract:

Objective To investigate the effect of intubation with electromyographic (EMG) endotracheal tubes versus conventional wire-reinforced (CWR) tubes on the incidence of postoperative sore throat (POST) in patients undergoing thyroidectomy under general anesthesia and identify the risk factors for POST. Methods We retrospectively collected the clinical data from a cohort of 245 patients undergoing elective thyroid surgery under general anesthesia at the Sixth Affiliated Hospital of Sun Yat-sen University between October, 2024 and March, 2025. Patients received intubation with either EMG endotracheal tubes (n=100) or CWR tubes (n=145) during the operation, and the incidences of POST and other postoperative complications were compared between the two groups. Propensity score matching (PSM) was applied to adjust for the baseline differences, and multivariate logistic regression analysis was used to identify independent risk factors for POST. Results Comparisons of the baseline data revealed significant differences between the two groups (P<0.05). After PSM, 90 patients in EMG group and 75 in CWR group were included in the final analysis with matching baseline characteristics (P>0.05). Post-matching analysis showed that the EMG group had a shorter operative time (P=0.002) but a higher incidence of POST (P=0.001). Multivariate logistic regression identified the use of EMG tubes (OR=17.50, 95% CI: 2.25-136.03, P<0.01) as an independent risk factor for POST. Conclusion Intubation with EMG endotracheal tubes can shorten the operative time and allow recurrent laryngeal nerve monitoring during thyroidectomy under general anesthesia, but their structural design may increase the risk of POST. Clinical decisions should be made to balance nerve protection and postoperative patient comfort by selecting appropriate tube types and optimizing intubation strategies to enhance perioperative outcomes.

Key words: electromyographic endotracheal tube, postoperative sore throat, thyroidectomy, tracheal intubation, retrospective study