Uzun süreli entübasyon yapılmış hastalarda laringofaringeal etkilerin değerlendirilmesi

Abstract

Amaç,: Açık kardiyovasküler cerrahiler hem operasyon süresi hem de postoperatif yoğun bakımda takip süresi göz önüne alındığında entübasyon süresinin uzun olduğu bilinen ameliyatlardır. Biz bu çalışmada koroner cerrahisi sonrası uzun süre entübe kalmış hastalarda postoperatif dönemde gözlenen laringeal ve faringeal etkilenmeyi incelemek ve bu etkilerin oluşumuna zemin hazırlayan olası nedenleri araştırmayı amaçladık.

Materyal ve Metodlar: Çalışmaya kardiyovasküler cerrahi yapılan toplam 42 hasta dahil edildi. Tüm hastalar preoperatif (preop) dönemde ve postoperatif dönemde (ortalama 7.gün) endoskopik muayene edildi ve muayene bulguları kaydedildi.

Bulgular: Hastalar ortalama 61±9.98 yaşında, ortalama entübe kalma süresi 14.80±3.41saat, kullanılan entübasyon tüpünün iç çapı 8.02±0.4 mm idi. Preoperatif sigara içen hasta sayısı 25 (%59.52) ve preoperatif gastroözofageal reflü semptomu olan hasta sayısı 8 (% 19.04 ). Postoperatiflaringeal ve faringeal patolojik bulgu oranı %38.09 bulundu. Postoperatif laringeal ve faringeal patolojik bulgu olan hastalarda yaş, entübasyon süresi, preoperatif gastroözofageal reflü hastalığı şikayeti arasındaki ilişki isitatiksel açıdan anlamlı bulundu (p˂0,05).Ancak postoperatif patolojik bulgu ile cinsiyet, entübasyon tüpünün tipi ve çapı, sigara kullanma arasında anlamlı ilişki bulunmadı.

Sonuç: Yaş, gastroözofageal reflü hastalığı varlığı, entübasyon süresinin uzunluğu postoperatif laringofaringeal bulgu oluşumu için risk faktörü olarak tespit edildi.

Keywords

• Endotrakeal entübasyon,larinks,farinks,koroner cerrahi

Evaluation of laryngopharyngeal effects in patients long-term intubated

Abstract

Aim: Open cardiovascular surgery involves prolonged intubation, postoperatively in the intensive care unit monitoring. The purpose of this study was to investigate the effects of long-term intubation after coronary artery surgery on laryngeal and pharyngeal structures and the probable underlying causes for such effects.

Material and Methods: Forty two patients undergoing cardiovascular surgery were included in the study. All patients underwent endoscopic examination in the preoperative period and approximately 7th postoperative day.

Results: Mean age of the patients was 61±9.98 years, mean duration of intubation was 14.80±3.41 hours (h) and mean size of intubation tube used was 8.02±0.45 mm. The number of preoperative smokers was 25(59.52%), and number of patients with preoperative gastroesophageal reflux disease symptoms were 8(19.04%). The level of postoperative laryngeal and pharyngeal pathological findings were 38.09%. Postoperative laryngeal and pharyngeal pathological findings were correlated with age, length of intubation and preoperative presence of the gastroesophageal reflux disease symptoms (p˂0.05). However, no statistically significant correlation was determined between postoperative pathological finding and sex, tube type, tube diameter, smoking status.

Conclusion: Age, presence of gastroesophageal reflux disease, length of intubation were identified as risk factors for the development of postoperative pathological laryngopharyngeal findings. 

Keywords

• Endotracheal intubation,larynx,pharynx,coronary surgery

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