针刺复合麻醉对甲状腺良性结节消融术镇痛和应激的影响  

Effect of Acupuncture-combined Anesthesia on Analgesia and Stress Reactions in Benign Thyroid Nodule Ablation

作　　者：沈韩雄 严赟 马思杰 陈海红 王小平 沈睿 杨晓英 SHEN Han-xiong;YAN Yun;MA Si-jie;CHEN Hai-hong;WANG Xiao-ping;SHEN Rui;YANG Xiao-ying(Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of TCM,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属上海市中医医院

出　　处：《上海针灸杂志》2019年第7期772-775,共4页Shanghai Journal of Acupuncture and Moxibustion

基　　金：上海市科委课题(17401933400);上海申康医院发展中心上海市市级医院临床辅助科室能力建设项目(SHDC22015010);上海中医药大学预算内课题(2016YSN56)

摘　　要：目的观察针刺复合局部麻醉在甲状腺良性结节消融术中的镇痛效果和对应激反应的影响。方法将60例择期进行甲状腺良性结节微波消融术的患者随机分为治疗组和对照组,每组30例。对照组采用单纯局部麻醉,治疗组在对照组基础上采用针刺麻醉。比较两组各时间点[麻醉前(T0)、麻醉后(T1)、消融术中(T2)、手术结束(T3)]患者的平均动脉压(MAP)、心率(HR)、术毕VAS评分和T0、T2、T3时点血清皮质醇(Cor)、肾上腺素(E)、葡萄糖(Glu)水平的变化情况。结果治疗组T2MAP和HR与同组T0比较,差异均具有统计学意义(P<0.05);对照组T2、T3MAP和HR与同组T0比较,差异均具有统计学意义(P<0.05)。两组T2、T3MAP和HR比较,差异均具有统计学意义(P<0.05)。治疗组术后VAS评分为(1.69±1.43)分,对照组为(3.54±1.27)分,两组比较差异具有统计学意义(P<0.01)。治疗组T2、T3E和Glu水平与同组T0比较,差异均具有统计学意义(P<0.05)。对照组T2、T3各项应激指标与同组T0比较,差异均具有统计学意义(P<0.05)。两组T2、T3各项应激指标比较,差异均具有统计学意义(P<0.05)。结论针刺复合局部麻醉在甲状腺良性结节消融术中可有效镇痛,并能维持较稳定的血压和心率。Objective To observe the effect of acupuncture-combined anesthesia on analgesia and stress reactions in benign thyroid nodule ablation.Method Sixty patients who were going to receive microwave ablation for benign thyroid nodules were randomized into a treatment group and a control group,with 30 cases in each group.The control group was intervened by local anesthesia,and the treatment group was additionally given acupuncture anesthesia.For the two groups,the mean arterial pressure(MAP)and heart rate(HR)at each time point[before anesthesia(T0),after anesthesia(T1),during ablation(T2)and at the end of the operation(T3)]were compared,as well as the Visual Analogue Scale(VAS)at T3,the serum levels of cortisol(Cor),adrenaline(E)and glucose(Glu)at T0,T2 and T3.Result In the treatment group,the MAP and HR at T2 were significantly different from those at T0(P<0.05);in the control group,the MAP and HR at T2 and T3 were significantly different from those at T0(P<0.05).There were significant differences in the MAP and HR between the two groups at T2 and T3(P<0.05).After the operation,the VAS score was(1.69±1.43)in the treatment group versus(3.54±1.27)in the control group,and the between-group difference was statistically significant(P<0.01).In the treatment group,the levels of E and Glu at T2 and T3 were significantly different from those at T0(P<0.05).In the control group,the stress indicators at T2 and T3 were significantly different from those at T0(P<0.05).There were significant differences in the stress indicators between the two groups at T2 and T3(P<0.05).Conclusion Acupuncture-combined anesthesia can produce effective analgesic effect in benign thyroid nodule ablation,and it basically can maintain the stability of blood pressure and HT.

关 键 词：针刺麻醉 电针 甲状腺切除术 甲状腺微波消融术 针灸研究 

分 类 号：R246.2[医药卫生—针灸推拿学]