针刺麻醉复合小剂量瑞芬太尼用于甲状腺良性结节消融术的临床疗效观察  

Observation on the Effect of Combined Anesthesia of Acupuncture and Low-dose Remifentanil on the Microwave Ablation for Patient with Benign Thyroid Nodules

作　　者：沈韩雄[1] 严赟[1] 曲立哲[1] 马思杰[1] 杨晓英[1] SHEN Han-xiong;YAN Yun;QU Li-zhe;MA Si-jie;YANG Xiao-ying(Department of Anesthesiology,City Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai,200070,Chin)

机构地区：[1]上海中医药大学附属市中医医院麻醉科,上海200070

出　　处：《现代生物医学进展》2018年第10期1936-1939,共4页Progress in Modern Biomedicine

基　　金：上海市卫生和计划生育委员会基金项目(201640034);上海市科学技术委员会基金项目(17401933400);上海中医药大学预算内项目(2016YSN56)

摘　　要：目的:探讨小剂量瑞芬太尼复合针刺麻醉在甲状腺良性结节消融术中的麻醉镇痛效果。方法:选取2015年6月至2016年6月在我院进行甲状腺良性结节射频消融术的患者71例,并将其随机分为对照组(n=35)和复合麻醉组(n=36)。对照组患者接受单纯芬太尼麻醉,复合麻醉组患者接受小剂量瑞芬太尼复合针刺麻醉,观察和比较两组患者麻醉前(T0)、麻醉后(T1)、消融术中(T2)、手术结束(T3)时患者的平均动脉压(MAP)、心率(HR)、血氧饱和度(HPO_2)和VAS评分。结果:复合麻醉组患者T2和T3时间点MAP(95.00±6.09,90.86±3.23)(P<0.05)、HR值(65.19±3.52,75.03±6.00)均显著低于对照组(P<0.05),HPO_2水平(98.78±1.15,97.81±1.47)均显著高于对照组(P<0.05),VAS评分(3.25±1.38,1.69±1.43)均显著低于对照组(P<0.05)。结论:电针刺激结合小剂量瑞芬太尼复合麻醉用于甲状腺良性结节消融术可有效镇痛并维持较稳定的血压和心率,效果明显优于单纯芬太尼麻醉。Objective： To investigate the analgesic effect of combined anesthesia of acupuncture and low-dose remifentanil in microwave ablation for patient with benign thyroid nodules.Methods： Seventy-one benign thyroid nodules patients receiving microwave ablation from July 2015 to July 2016 were randomly assigned to the control group and the combined anesthesia group.Patients in the control group received Fentanyl anesthesia,while patients in the combined anesthesia group received combined anesthesia of acupuncture and low-dose Remifentanil during microwave ablation.The MAP,HR,HPO2 and VAS scores were recorded and compared between two groups before anesthesia（T0）,after anesthesia（T1）,during ablation（T2） and at the end of ablation（T3）.Results： Compared with the control group,the MAP（95.00±6.09,90.86±3.23） and HR（65.19±3.52,75.03±6.00） were significantly lower in the combined anesthesia group at T2 and T3（P〈0.05）,the HPO2（98.78±1.15,97.81±1.47） were significantly lower in the combined anesthesia group（P〈0.05）,and the VAS（3.25±1.38,1.69±1.43） scores were significantly lower in the combined anesthesia group（P〈0.05）.Conclusion： Combined anesthesia of acupuncture and low-dose Remifentanil had an effective analgesic action with stable blood pressure and heart rate,which was better than fentanyl.

关 键 词：针刺麻醉 甲状腺射频消融术 瑞芬太尼 

分 类 号：R614[医药卫生—麻醉学] R653[医药卫生—外科学]