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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Patient tolerance of awake, in-office laryngeal procedures: a multi-institutional perspective.
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Patient tolerance of awake, in-office laryngeal procedures: a multi-institutional perspective.

机译：病人对清醒，办公室内喉镜手术的耐受性：多机构角度。

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OBJECTIVES/HYPOTHESIS: An increasing number of laryngeal procedures are performed in the office. However, little is known about how well these procedures are tolerated and what factors determine success or failure. STUDY DESIGN: Prospectively collected patient and physician surveys from five surgeons at two institutions describe patient tolerance of awake, in-office laryngeal procedures (AIOLPs). METHODS: There were 154 procedures performed in a 6-month period, including vocal fold injection (VFI) (72%), laser treatment (19%), and transnasal esophagoscopy (3%). Average duration of procedure was 13 +/- 8 minutes. RESULTS: Patients reported an average of 37 of 100 on a discomfort scale, with 0 representing no discomfort and 100 representing maximal discomfort. Ninety-three percent of patients would undergo another procedure, and 96% would recommend AIOLPs to other patients. Procedures were completed successfully in 92%. Most common surgeon-reported difficulties included copious secretions and uncontrolled gag reflex. Procedures that involved such difficulties had a significantly lower rate of procedure completion, 73% vs. 96%, P = .0001. High preprocedure anxiety did not adversely impact patient comfort or procedure completion rate. There was no difference in discomfort scores based on VFI approach or patient familiarity with AIOLPs. There was a significant difference in discomfort score between patients with successful first-approach VFI and those who required a change in VFI approach, 36.0 vs. 61.3, respectively, P = .003. The rate of requiring a second and third VFI approach was 4.6% and 2.8%, respectively. CONCLUSIONS: This study encompasses multiple diagnoses, procedures, VFI techniques, and methods of anesthesia. AIOLPs are exceptionally well tolerated by patients, resulting in extremely high completion and satisfaction rates.
机译：目的/假设：办公室中进行的喉镜手术数量越来越多。但是，人们对这些程序的耐受程度以及决定成功与否的因素知之甚少。研究设计：前瞻性地收集了来自两个机构的五名外科医生的患者和医师调查，描述了患者对清醒，办公室内喉镜操作（AIOLP）的耐受性。方法：六个月内共进行了154例手术，包括声带注射（VFI）（72％），激光治疗（19％）和经鼻食管镜检查（3％）。平均手术时间为13 +/- 8分钟。结果：根据不适等级，患者平均报告37例，其中0表示无不适，100表示​​最大不适。 93％的患者将接受另一种手术，而96％的患者会向其他患者推荐AIOLP。程序成功完成了92％。外科医生报告的最常见困难包括分泌物过多和堵嘴反射失控。涉及此类困难的程序的程序完成率明显较低，分别为73％和96％，P = .0001。术前高度焦虑不会对患者的舒适度或手术完成率产生不利影响。基于VFI方法或患者对AIOLP的熟悉程度，其不适评分没有差异。成功的首次接近VFI患者与需要改变VFI方法的患者之间的不适评分存在显着差异，分别为36.0和61.3，P = .003。要求第二种和第三种VFI方法的比率分别为4.6％和2.8％。结论：这项研究包括多种诊断，程序，VFI技术和麻醉方法。患者对AIOLP的耐受性特别好，从而导致极高的完成率和满意度。

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