颈丛神经阻滞联合静吸全麻在分化型甲状腺癌中的应用价值  

The Application Value of Cervical Plexus Block Plus Intravenous General Anesthesia in Differentiated Thyroid Carcinoma

作　　者：殷佳晗 陈颖 YIN Jiahan;CHEN Ying(Department of Anesthesiology,Shanghai Ruijin Rehabilitation Hospital,Shanghai 200023,China)

机构地区：[1]上海市瑞金康复医院麻醉科,上海200023

出　　处：《中国卫生标准管理》2022年第5期59-62,共4页China Health Standard Management

摘　　要：目的分析在分化型甲状腺癌术中采用超声引导的颈从神经阻滞联合静吸复合全麻对其机体应激反应的具体影响。方法抽取2018年6月—2020年12月医院74例分化型甲状腺癌患者,采用随机数字表法分组,观察组患者术中为超声引导颈丛神经阻滞联合静吸复合全麻,对照组术中为常规全身麻醉,比较两组麻醉期间血糖与肾上腺素的测定结果、术中麻醉质量、麻醉不良反应率以及一般麻醉指标。结果两组T_(0)血糖与肾上腺素相比差异无统计学意义(P>0.05),T_(1)、T_(2)观察组的血糖与肾上腺素均低于对照组,差异有统计学意义(P<0.05);观察组的麻醉优良率为97.30%,对照组为78.38%,差异有统计学意义(P<0.05);观察组的麻醉不良反应率为2.70%,对照组为24.32%,差异有统计学意义(P<0.05);芬太尼与维库溴安的药物用量观察组较对照组减少,气管导管拔除时间以及苏醒时间观察组较同期对照组缩短,差异有统计学意义(P<0.05)。结论在分化型甲状腺癌手术中采用超声引导的颈丛神经阻滞联合静吸复合全麻可有效缓解术中应激反应,并提升麻醉质量,且安全性良好。Objective To analyze the specific effects of ultrasoundguided cervical nerve block combined with inhalation combined with general anesthesia on the stress response of differentiated thyroid cancer. Methods A total of 74 patients with differentiated thyroid cancer in our hospital from June 2018 to December 2020 were selected and randomly divided into groups by number table method. Patients in the observation group were treated with ultrasonic-guided cervical plexus nerve block combined with intravenous aspiration combined with general anesthesia during operation, while patients in the control group were treated with routine general anesthesia during operation, the results of blood glucose and epinephrine during anesthesia, anesthesia quality, anesthesia adverse reaction rate and general anesthesia indexes were compared between the two groups. Results Compared with the two groups of T_(0)blood glucose and epinephrine, the difference was not statistically significant (P > 0.05). The blood glucose and epinephrine of the T_(1)and T_(2)in observation group were lower than those of the control group, and the difference was statistically significant (P <0.05). The excellent and good rate of anesthesia in the observation group was 97.30%, and that in the control group was 78.38%, and the difference was statistically significant (P < 0.05).The adverse reaction rate of anesthesia in the observation group was 2.70%and that in the control group was 24.32%, and the difference was statistically significant (P < 0.05). The drug dosages of fentanyl and vecuronide in the observation group were lower than those in the control group, and the tracheal catheter removal time and recovery time in the observation group were shorter than those in the control group at the same period, and the differences were statistically significant (P < 0.05). Conclusion Ultrasound-guided cervical plexus nerve block combined with inhalation combined with general anesthesia in the operation of differentiated thyroid cancer can effectively relieve the int

关 键 词：分化型甲状腺癌 颈丛神经阻滞 超声 静吸复合全身麻醉 应激反应 不良反应 

分 类 号：R736[医药卫生—肿瘤]