丙泊酚复合异氟烷吸入麻醉对甲状腺癌患者颈部切除术应激反应及疼痛程度的影响  

Effect of propofol compound isofl urane inhalation anesthesia on neck resection stress response and pain degree in patients with thyroid cancer

作　　者：丰小雷 沈露露 Feng Xiaolei;Shen Lulu(Anesthesiology Department of Huai'an First People's Hospital Branch,Jiangsu Huai'an 223200,China;Anesthesiology Department of Huai'an Second People's Hospital,Jiangsu Huai'an 223200,China)

机构地区：[1]淮安市第一人民医院分院麻醉科,江苏淮安223200 [2]淮安市第二人民医院麻醉科,江苏淮安223200

出　　处：《临床普外科电子杂志》2024年第3期20-22,40,共4页Journal of General Surgery for Clinicians(Electronic Version)

摘　　要：目的探讨甲状腺癌行颈部甲状腺切除术患者应用丙泊酚复合异氟烷吸入麻醉对应激反应、疼痛程度的影响。方法选取2022年1月至2024年1月淮安市第一人民医院分院收治的择期行颈部甲状腺切除术的甲状腺癌患者80例,根据随机数字表法分成观察组与对照组各40例。对照组采取舒芬太尼联合丙泊酚麻醉诱导,术中采取丙泊酚复合瑞芬太尼维持麻醉,观察组在对照组的麻醉诱导及维持麻醉基础上,加用异氟烷吸入维持麻醉。对比两组患者术前、麻醉后5min、术毕时的应激反应,以及术后不同时间点的视觉模拟评分法(visual analogue scale,VAS)评分。结果两组患者麻醉后5min、术毕时的皮质醇与C反应蛋白水平均较术前升高,但术后观察组皮质醇与C反应蛋白水平均低于对照组,差异均有显著性(P<0.05)。术后2h,两组患者的VAS评分较术后30min升高,差异有显著性(P<0.05)。术后4h、12h,两组患者的VAS评分均较术后2h降低,差异有显著性(P<0.05)。观察组患者术后30min、2h、4h的VAS评分均低于对照组,差异均有显著性(P<0.05),两组患者术后12h的VAS评分无显著差异(P>0.05)。结论行颈部甲状腺切除术的甲状腺癌患者,采取丙泊酚复合异氟烷吸入麻醉,能显著缓解患者应激反应,减轻术后疼痛程度。Objective To investigate the effects of propofol combined with isoflurane inhalation anesthesia on stress response and pain level in patients undergoing neck thyroidectomy for thyroid cancer.Method Eighty patients with thyroid cancer who underwent elective cervical thyroidectomy at the branch of Huai'an First People's Hospital from January 2022 to January 2024 were selected and randomly divided into an observation group and a control group,with 40 patients in each group,using a random number table method.The control group received sufentanil combined with propofol anesthesia induction,while propofol combined with remifentanil was used to maintain anesthesia during surgery.The observation group received isofl urane inhalation to maintain anesthesia based on anesthesia induction and maintenance in the control group.Compare the stress responses of two groups of patients before surgery,5 minutes after anesthesia,and at the end of surgery,as well as the degree of pain at diff erent time points after surgery.Result The levels of cortisol and C-reactive protein in both groups of patients increased 5 minutes after anesthesia and at the end of surgery compared to before surgery.However,the levels of cortisol and C-reactive protein in the postoperative observation group were lower than those in the control group,and the diff erences were signifi cant(P<0.05).After 2 hours postoperatively,the VAS scores of both groups of patients increased signifi cantly compared to 30 minutes postoperatively(P<0.05).At 4 and 12 hours postoperatively,the VAS scores of both groups of patients decreased signifi cantly compared to 2 hours postoperatively(P<0.05).The VAS scores of the observation group were signifi cantly lower than those of the control group at 30 minutes,2 hours,and 4 hours after surgery(P<0.05),while there was no signifi cant diff erence in VAS scores between the two groups at 12 hours after surgery(P>0.05).Conclusion For thyroid cancer patients undergoing cervical thyroidectomy,propofol combined with isofl urane inhalation

关 键 词：甲状腺癌 颈部切除术 丙泊酚 异氟烷吸入麻醉 应激反应 

分 类 号：R614[医药卫生—麻醉学] R736.1[医药卫生—外科学]