右美托咪定在喉返神经监测甲状腺手术中的防呛咳作用  

Prevention of Coughing Reflex by Dexmedetomidine in Thyroid Surgery Using Recurrent Laryngeal Nerve Monitoring

作　　者：周妙苗[1] 李卉[1] 钟琦[1] 彭勉[1] ZHOU Miaomiao;LI Hui;ZHONG Qi;PENG Mian(Central South Hospital of Wuhan University,Wuhan 430071,Hubei,China)

机构地区：[1]武汉大学中南医院

出　　处：《贵州医科大学学报》2019年第5期583-586,共4页Journal of Guizhou Medical University

基　　金：国家自然科学基金项目(81471858)

摘　　要：目的:探讨右美托咪定诱导对术中使用喉返神经监测甲状腺手术气管插管时的防呛咳作用。方法:术中使用喉返神经监测甲状腺手术患者60例,随机均分为右美托咪定组(A组)和对照组(B组),比较两组患者的插管条件(喉镜置入难易程度和声门位置)、插管情况、呛咳反应(插管时和术中),分别记录插管前(T0)、插管即刻(T1)、插管后15s(T2)、插管1min(T3)时的心率和平均动脉压。结果:A组和B组喉镜置入难易程度和声门位置评分比较,差异无统计学意义(P>0.05);A组的呛咳反应明显比B组轻(P<0.01),A组插管一次性成功率高于B组(P<0.05);T0时点A组与B组的心率和平均动脉压比较,差异无统计学意义(P>0.05);T1、T2、T3时点A组患者的HR及MAP低于B组(P<0.05)。结论:右美托咪定可以抑制甲状腺手术术中的呛咳反应,并减轻心血管反应。Objective:To investigate the effect of dexmedetomidine on coughing reflex detected by recurrent laryngeal nerve monitoring during tracheal intubation and intraoperative thyroid surgery.Methods:Sixty patients with recurrent laryngeal nerve monitoring in thyroid surgery were randomly divided into dexmedetomidine group(group A)and control group(group B).We examined the intubation conditions(difficulty of laryngoscope placement and glottal position),intubation,cough response during intubation and the operation of surgery),cardiovascular response(at pre-intubation(T 0),intubation immediately(T 1),15 s after intubation)(T 2)),heart rate and mean arterial pressure at 1 min(T 3)after incubation.Results:There were no statistically significant differences in the degree of difficulty in laryngoscopy and glottal position between group A and group B(P>0.05).The cough response was significantly weaker in group A than that in group B(P<0.01).In terms of first intubation,the success rate of intubation in group A was higher than that in group B(P<0.05).There were no significant differences in the heart rate and mean arterial pressure between group A and group B at time T0(P>0.05),but the HR and MAP were lower in group A than those in group B at T 1,T 2 and T 3(P<0.05).Conclusion:Dexmedetomidine can inhibit cough response and cardiovascular response during thyroid surgery.

关 键 词：右美托咪定 喉返神经监测 甲状腺手术 呛咳反应 心血管反应 

分 类 号：R614.4[医药卫生—麻醉学]