不同膨胀液对腔镜甲状腺手术患者术后皮肤粘连、疼痛及炎症反应的影响  

Effect of different swelling fluid on postoperative skin adhesion, pain and inflammation in patients undergoing endoscopic thyroidectomy

作　　者：韦倩颖 张卧[1] 张晴 WEI Qian-ying;ZHANG Wo;ZHANG Qing(Hangzhou First Peopled Hospital,Hangzhou,Zhejidng 310006,China)

机构地区：[1]杭州市第一人民医院,浙江310006

出　　处：《中国地方病防治》2021年第6期508-511,共4页Chinese Journal of Control of Endemic Diseases

摘　　要：目的探讨不同膨胀液对腔镜甲状腺手术患者术后皮肤粘连、疼痛及炎症反应的影响。方法选择2019年6月至2020年12月在某院接受腔镜甲状腺手术患者80例。依据膨胀液的配置不同,分为对照组和试验组,各40例。试验组采用生理盐水250 ml+肾上腺素0.5 mg+罗哌卡因150 mg+曲安奈德注射液80 mg配置膨胀液,对照组采用生理盐水250 ml+肾上腺素0.5 mg+罗哌卡因150 mg配置膨胀液。记录术后12 h、24 h、48 h、72 h视觉模拟疼痛评分(VAS)。分别于术前(T_(0))及术后1 d(T_(1))、术后3 d(T_(2))、术后7 d(T_(3))采集静脉血,检测C反应蛋白(CRP)和白介素(IL)-6水平。记录术后皮肤粘连程度,包括轻、中、重度。结果2组患者术后VAS评分呈先升高后下降的趋势(P<0.05)。与对照组比较,试验组术后12 h、24 h、48 h和72 h的VAS评分均较低,差异有统计学意义(P<0.05)。2组患者T_(1-4)的CRP和IL-6水平均呈先上升后下降趋势,且2组患者T_(1-4)的CRP和IL-6水平均高于T_(0)(P<0.05)。2组患者T_(0)的CRP和IL-6水平比较,差异无统计学意义(P>0.05),但试验组T_(1-4)的CRP和IL-6水平显著低于对照组,差异均有统计学意义(P<0.05)。2组患者VAS评分、CRP和IL-6组间和不同时点间的主效应以及组间和时点间交互效应均有统计学意义(P<0.05)。试验组术后皮肤粘连情况优于对照组,中度皮肤粘连比例低于对照组,差异有统计学意义(P<0.05)。结论含曲安奈德联合罗哌卡因的膨胀液可以减轻腔镜甲状腺手术患者术后疼痛及炎症反应,降低术后皮肤粘连程度。Objective To explore the effect of different swelling fluid on postoperative skin adhesion,pain and inflammation in patients undergoing endoscopic thyroidectomy.Methods From Jun.2019 to Dec.2020,80 patients underwent endoscopic thyroidectomy in one hospital were selected.According to the configuration of swelling fluid,it was divided into control group and experimental group,40 cases each.In the experimental group,250 ml of normal saline+0.5 mg of adrenaline+150 mg of ropivacaine+80 mg of triamcinolone acetonide injection were used as the swelling fluid,while in the control group,250 ml of normal saline+0.5 mg of adrenaline+150 mg of ropivacaine were used as the swelling fluid.The visual analogue pain score(VAS)was recorded at 12 h,24 h,48 h and 72 h after operation.Venous blood was collected before operation(T_(0)),1 day after operation(T_(1)),3 days after operation(T_(2))and 7 days after operation(T_(3)),respectively,and the levels of C-reactive protein(CRP)and interleukin-6(IL-6)were measured.The degree of postoperative skin adhesion was recorded,including mild,moderate and severe.Results The VAS score in the two groups increased first and then decreased(P<0.05).Compared with the control group,the VAS scores in the experimental group were lower at 12 h,24 h,48 h and 72 h after operation,and the difference was statistically significant(P<0.05).The level of CRP and IL-6 at T_(1-4) in the two groups increased first and then decreased,and the level of CRP and IL-6 at T_(1-4) in the two groups was higher than that at T_(0)(P<0.05).There was no significant difference in the levels of CRP and IL-6 between the two groups(P>0.05),but the levels of CRP and IL-6 in the experimental group were significantly lower than those in the control group(P<0.05).There were significant differences in main effect between groups and different time points,and interaction between groups and time points(P<0.05).The postoperative skin adhesion in the experimental group was better than that in the control group,and the proportion of modera

关 键 词：腔镜甲状腺手术 膨胀液 疼痛 炎症反应 皮肤粘连 

分 类 号：R581[医药卫生—内分泌]