甲状腺颈丛阻滞后应激反应变化  

Stress Reaction Changes of Thyroid after Cervical Plexus Block

作　　者：崔旭 

机构地区：[1]连云港海州区第二人民医院,江苏连云港222023

出　　处：《中外医学研究》2015年第8期10-11,共2页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的：观察甲状腺手术颈丛阻滞后对患者应激反应。方法：选择择期手术无心血管疾患、无心情紧张、非甲亢患者44例。麻醉采用双侧颈浅、术测颈深的阻滞方法，颈深分别阻滞颈椎3、4、5，回抽无血液、脑脊液，每个点采用0.25%布比卡因3--4 ml，颈浅8--10 ml注射，回抽无血液。均未加肾上腺素。分别于术前l d、麻醉后5、15、30 min（切皮前）取肘部静脉血液，测定麻醉前1 d、麻醉后儿茶酚胺、血糖、皮质醇值，观察并记录BP及HR的变化。结果：44例患者颈丛神经阻滞5 min后，BP、HR、AE、NE、DA、Glu、Cor开始增加，15～20 min达到高峰，持续30 min后渐下降，与术前1 d比较差异均有统计学意义（P〈0.05）。结论：甲状腺颈丛阻滞后有明显的应激反应，导致血压心率升高。Objective：To observe the patients with stress reaction of cervical plexus block on operation of thyroid.Method：Forty-four patients without cardiovascular diseases or mental tension or hyperthyroidism were selected.The anesthesia was used for measurement of bilateral superficial cervical,block neck deep.Deep cervical respectively blocked 3,4,5 of cervical spine,withdrawing no blood and cerebrospinal fluid,each point with 0.25% bupivacaine 3-4 ml,injected 8-10 ml in superficial cervical,withdrawing no blood,neither joined the adrenaline.The elbow venous blood were collected one day before the operation,after anesthesia,5,15,30 min（before skin incision）,the catecholamines,blood glucose,cortisol value on one day before anesthesia and after anesthesia,the changes of BP and HR were observed and recorded.Result：In 44 patients,the BP,HR,AE,NE, DA,Glu,Cor were increased significantly at 5 min after completion of cervical plexus block,reached to peak level at 15-20 min,and lasted until 30 min,compared with one day before operation,the differences were statistically significant（P〈0.05）.Conclusion：Thyroid after cervical plexus block has obvious stress reaction,cause the blood pressure and heart rate increased.

关 键 词：甲状腺 颈丛神经阻滞 儿茶酚胺 血糖 皮质醇 

分 类 号：R614[医药卫生—麻醉学]