酮咯酸氨丁三醇注射液对甲状腺良性肿瘤切除患者的应激状况及镇痛效果研究  

Stress status and analgesic effect of ketorolac tromethamine injection in patients with benign thyroid tumor resection

作　　者：梁磊 袁婉秋[1] 张文婷[1] 巫志国[1] 何德[2] 彭洪[1] Liang Lei;Yuan Wanqiu;Zhang Wenting;Wu Zhiguo;He De;Peng Hong(Department of Anesthesiology,The People's Hospital of Pingxiang,Pingxiang,Jiangxi,337000,China;Department of Thyroid Surgery,The People's Hospital of Pingxiang,Pingxiang,Jiangxi,337000,China)

机构地区：[1]江西省萍乡市人民医院麻醉科,江西萍乡337000 [2]江西省萍乡市人民医院甲状腺外科,江西萍乡337000

出　　处：《当代医学》2020年第30期19-21,共3页Contemporary Medicine

基　　金：萍乡市科技支撑计划项目(2018PY010)。

摘　　要：目的研究酮咯酸氨丁三醇注射液对甲状腺良性肿瘤切除患者的应激状况及镇痛效果。方法选取本院2018年10月至2019年12月收治的行甲状腺良性肿瘤切除术患者60例为研究对象,采用随机数字表法分为研究组和对照组,每组30例。两组患者均行气管插管全身麻醉处理,麻醉诱导:丙泊酚+舒芬太尼+顺式阿曲库铵;麻醉维持:吸入1%~3%七氟醚,泵注丙泊酚。手术结束前,对照组静脉推注0.9%氯化钠5 mL,研究组静脉推注酮咯酸氨丁三醇注射液30 mg。观察两组患者应激水平变化情况,比较镇痛效果。结果研究组手术开始1 h(T1)以及术后1 h(T2)时,平均动脉压、心率和血浆皮质醇(Cor)各项指标均明显低于对照组(P<0.05)。两组拔管后第1、4、8小时的血氧浓度比较差异无统计学意义;研究组拔管后第1、4、8小时VAS评分明显低于对照组(P<0.05),且Ramsay镇静评分明显优于对照组(P<0.05)。研究组出现不良反应7例,对照组出现不良反应6例,两组不良反应发生率比较差异无统计学意义。结论甲状腺良性肿瘤患者应用酮咯酸氨丁三醇注射液后,能明显减轻患者的应激反应,镇痛效果良好,明显减少镇静过度及呼吸抑制情况,为甲状腺外科手术麻醉提供足够的发展空间,临床应用价值较高。Objective To study the stress state and analgesic effect of ketorolac tromethamine injection in patients with benign thyroid tumor resection.Methods From October 2018 to December 2019,60 patients who underwent thyroidectomy in our hospital were selected as the study objects.The patients were divided into study group and control group,with 30 cases in each group.Anesthesia induction:Propofol+sufentanil+cisatracurium;anesthesia maintenance:inhalation of 1%-3%sevoflurane,pump propofol.Before the operation,the control group was given 5 mL 0.9%sodium chloride intravenously,and the study group was given 30 mg ketorolac tromethamine intravenously.The stress levels of the two groups were observed and the analgesic effect was compared.Results The indexes of mean arterial pressure,heart rate and cortisol(Cor)in the study group were significantly lower than those in the control group(P<0.05).There was no significant difference in blood oxygen between the study group and the control group at the 1st,4th and 8th hours after the tube was pulled out.VAS score of the study group at the 1st,4th and 8th hours after the tube was pulled out was significantly lower than that of the control group(P<0.05),and Ramsay Sedation score was significantly better than that of the control group(P<0.05).There were 7 adverse reactions in the study group and 6 in the control group,there was no significant difference of incidence of adverse reactions between the two groups.Conclusion After the application of ketorolac tromethamine injection to the patients with thyroid benign tumor,the stress response of the patients was significantly reduced,the analgesic effect was good,the sedation and respiratory inhibition were significantly less,which provided enough development space for the anesthesia of thyroid surgery,and the clinical application value was higher.

关 键 词：甲状腺良性肿瘤切除 酮咯酸氨丁三醇注射液 应激状况 镇痛效果 

分 类 号：R614[医药卫生—麻醉学] R736.1[医药卫生—外科学]