麻醉舒适医疗在甲状腺手术中的临床研究  

The clinical study of comfortable medical with anesthesia in the thyroid surgery

作　　者：江燕[1] 黄瑞鑫[1] 王银珊[1] 洪弥琼[1] 张燕[1] 

机构地区：[1]广东省揭阳市人民医院麻醉科,522000

出　　处：《重庆医学》2014年第9期1041-1043,共3页Chongqing medicine

摘　　要：目的探讨一种能达到舒适医疗目的的颈丛麻醉的辅助麻醉方案。方法将80例择期行双侧甲状腺手术的女性患者分为对照组(A组)、氟芬组(B组)、布托啡诺组(C组)、右美托咪定联合芬太尼组(D组),每组20例。记录各组颈丛阻滞前10min(T0)、颈丛操作(T1)、切皮(T2)、分离甲状腺下极(T3)、缝皮(T4)的收缩压(SBP)、舒张压(DBP)、心率(HR)、血氧饱和度(SpO2)、Narcotrend麻醉/脑电意识深度监测指数(NTI)。结果 B组和A组同时点比较差异无统计学意义(P>0.05);C组在T3、T4时点SBP、DBP、HR高于T0,同时点上较A组、B组有所降低且差异有统计学意义(P<0.05);D组T2、T3、T4时点的HBP、DBP、HR较T1下降,差异有统计学意义(P<0.05);D组在T3、T4时点上的SBP、HDP、HR较其他3组下降,差异有统计学意义(P<0.05);D组NTI在T1、T2时点与A组、B组比较,差异有统计学意义(P<0.05),在T3、T4时点较其他3组镇静效果好,差异有统计学意义(P<0.05)。结论颈丛神经阻滞辅以右美托咪定行甲状腺手术能降低患者的应激反应,有适度的镇静、痛效果,可达到舒适医疗的目的。Objective To explore a kind of comfortable medical for ervical plexus anesthesia auxiliary anesthesia .Methods 80 thyroidectomy female patients were randomly divided into normal saline group （group A） ,droperidol-fentanyl group （group B） ,bu-torphanol group （group C） ,dex group （group D） ,20 cases in each group .The change of systolic blood pressure （SBP） ,diastolic blood pressure （DBP） ,heart rate （HR） ,blood oxygen saturation （SpO2 ） ,narcotrend index （NTI） were monitored .The above pa-rameters were recorded at 10 min before cervical plexus（T0 ） ,cervical plexus operation（T1 ） ,skin incision（T2 ） ,separation of thyroid upper extreme（T3 ）and suture（T4 ） .Results There was no significant difference between the groups A and B at the same time point （P＆gt;0 .05） .In group C ,the SBP、DBP、HR at T3 and T4 were significant higher than at T0 ,and at the same point the A and B group decreased statistically significant （P＆lt;0 .05） .In group D ,the SBP、DBP、HR at T2 、T3 、T4 were significant lower than at T1 ,espe-cially at T4 compared to at T0 （P＆lt;0 .05） .Compared to group A ,B ,C ,the SBP、DBP、HR in group D were lower at T3 and T4（P＆lt;0 .05） .NTI in group D at T1 、T2 had significant difference compared with group A and B （P＆lt;0 .05） ,especially at T3 、T4 were sta-tistically significant than the other three groups（P＆lt;0 .05） ,sedation was better than the other groups .Conclusion Cervical plexus block supplemented by dex can reduce the patient′s stress response and reach moderate sedation analgesia to comfortable medical purposes .

关 键 词：麻醉 神经传导阻滞 甲状腺切除术 清醒镇痛 

分 类 号：R614[医药卫生—麻醉学]