改良电针在甲状腺次全切除术中的应用  

Effect of electroacupuncture in patients undergoing subtotal thyroidectomy

作　　者：熊国强[1] 覃军[1] 黄仁健[1] 陈远林[1] 

机构地区：[1]深圳市龙岗中心医院麻醉科,518116

出　　处：《中国现代药物应用》2009年第16期10-12,共3页Chinese Journal of Modern Drug Application

摘　　要：目的研究改良电针刺激在甲状腺次全切除术中的应用。方法择期甲状腺次全切除术的患者98例，ASAⅠ～Ⅱ级，随机分为A（改良电针加颈丛阻滞组49例）、B（颈丛阻滞组49例）两组，A组选择49例患者入室后于双侧“合谷”、“内关”穴用韩氏镇痛仪电极片选用2／100Hz等幅波穴位刺激，10min后行颈从神经阻滞（颈4横突一点法，一边深、浅丛阻滞法，另一边浅丛阻滞）；B组采用行颈丛神经阻滞，方法同A组。围术期监测平均动脉压（MAP）、心率（HR）、动脉血氧饱和度（SaO2）。分别于麻醉前（t1）、双侧颈丛阻滞后10min（t2）、手术切皮时（t3）、手术结束缝皮时（t4）、术后5min（t5）抽取中心静脉血测定血糖及皮质醇。记录患者术中疼痛强度评分（visual analog scale，VAS）和镇静与紧张程度评分（verbal stress scale，vss），并记录并发症和不良反应。结果围术期两组HR、MAP、血糖、皮质醇、两组术中均有所增加，B组升高更明显，差异有显著性（P〈0．01）；SaO2组内、组间比较差异无显著性（P〉0．05）。术中VAS和VSS评分，A组明显少于B组（P〈0．01）。结论改良电针刺激可加强颈从神经阻滞在甲状腺次全切除术中的麻醉效果，术中应激反应轻微。Objective To investigate Effect of electroacupuncture in patients undergoing subtotal thyroidectomy. Methods 98 ASA Ⅰ - Ⅱ patients undergoing subtotal thyroidectomy were randomly divided into two groups （n = 49 each）according to different anesthesia methods： Groud A： electroacupuneture combined with cervical plexus block ; Groud B ： cervical plexus block only. MAP, HR, SaO2 were monitered during the operation; Blood samples were taken from internal jugular vein at the time before anesthesia （ t1 ）, 10 min after cervical plexus block （t2）, at the skinincision （t3）, after operation （t4）and 5 min after Operation. Venous blood samples were taken for blood glucose concentration and cortisol concentration. Visual analog scale （VSA） and Verbal stress scale（VSS） were and side effects were recorded during the operation. Results MAP, HR, blood glucose concentration and cortisol concentration were increased in two groups, but group B was increased more than group A（P 〈0. 01）. SaO2 had no different in both groups. Scores of VSA and VSS were also lower in group A than those in group B （P 〈 0. 01 ）. Conclusion Electroacupuncture could enhance the effects of cervical plexus block,lower the stress reaction during subtotal thyroidectomy.

关 键 词：甲状腺次全切除术 改良电针刺激 颈丛阻滞 应激反应 

分 类 号：R614[医药卫生—麻醉学]