小切口甲状腺日间手术麻醉方式研究  

The anesthesia study of minimally-invasive thyroid surgery with short-stay discharge

作　　者：刘韧[1] 黄盛[2] 张再重[2] 王银模[1] 王瑜[2] 于向鸿[1] 

机构地区：[1]南京军区福州总医院麻醉科,福州350025 [2]南京军区福州总医院普通外科,福州350025

出　　处：《中华内分泌外科杂志》2015年第4期291-294,共4页Chinese Journal of Endocrine Surgery

基　　金：福建省科技计划项目（2012D020）;南京军区福州总医院科研基金（201129）

摘　　要：目的探讨全身麻醉和颈丛阻滞麻醉下行小切口甲状腺日间手术的安全性、可行性和有效性。方法2013年1月至6月南京军区福州总医院103例小切口甲状腺日间手术患者，按随机数字表法随机分为颈丛组（n=54例）和全麻组（n=49例），对比2组术中生命体征、血糖变化、麻醉效果、满意度、并发症和住院时间。结果2组均顺利完成手术，颈丛组术中收缩压高于全麻组（麻醉后5min（T1）：（904-7．0vs79±8．3）mmHg（1mmHg=0．133Kp）；肿瘤切除时（他）：（88±6．8V880±7．6）mmHg，P均〈0．05）；颈丛组术中心率高于全麻组（T1：130±18．2vs101±12．0次／min；T2：1204-19．7vs103±13．3次／min，P均〈0．05））；颈丛组麻醉恢复时间（0．34-0．14vs80．84-0．35）h和麻醉费用（1350±78vs2580±220）元均低于全麻组（P〈0．05）；2组血糖、麻醉认知、麻醉效果和麻醉并发症、麻醉满意度、住院时间和手术并发症差异无统计学意义（P〉0．05）。结论全身麻醉和颈丛阻滞麻醉下行小切口甲状腺日间手术均安全、有效，全身麻醉精神创伤小，颈丛阻滞麻醉恢复快、费用低。Objective To evaluate the feasibility, security and efficiency of general anaesthesia compared with regional anaesthesia for minimally-invasive thyroid surgery（MITS）with short-stay discharge. Methods 103 cases undergoing MITS with short-stay discharge from Jan. 2013 to Jun. 2013 in Fuzhou General Hospital were collected. 54 patients were operated under regional anaesthesia and 49 under general anaesthesia. All variables of patients including demographic characteristics, vital signs（ blood pressure, heart rate, blood glucose）during the op- eration, duration and type of operation, postoperative complications, difficulty in airway management and anesthe- sia consumption were recorded and analyzed. Results There was no difference in respect to level of blood glu- cose, length of hospital stay, discharge time, patient or operator satisfaction rate, anesthesia or operation complications rate between the two groups. Blood pressure（T1 ： （90 ±7. 0）vs（79 ±8. 3）mmHg, T2：（88 ±6. 8）vs（80 ±7.6） mmHg, P 〈0.05）and heart rate（Tl： （130± 18.2） vs（101 ±12. 0）/min,T2：（120 ± 19.7） vs（103 ±13.3）/min, P 〈0. 05） level were higher, while the recovery time of anesthesia（ （0. 3 ±0. 14）vs（0. 8 ±0. 35）h, P 〈0. 05） ）and anesthesia consumption（ （1350±78）vs（2580 ±220）yuan, P 〈0. 05） ）were lower in the regional anaesthesia group compared with those in the general anaesthesia group. Conclusions Both general anaesthesia and regional anaesthesia for MITS with short-stay discharge are safe and effective. General anesthesia has less psychological trauma, while regional anaesthesia has shorter recovery time and lower anesthetic consumption.

关 键 词：甲状腺疾病 日间手术 全身麻醉 区域阻滞麻醉 

分 类 号：R614[医药卫生—麻醉学]