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  本文選題：甲狀腺切除手術(shù)　切入點(diǎn)：右美托咪定　出處：《中國地方病防治雜志》2016年02期 　論文類型：期刊論文

【摘要】：目的探討甲狀腺切除手術(shù)麻醉中應(yīng)用右美托咪定輔助頸叢神經(jīng)阻滯的效果,并觀察其對血流動力學(xué)的影響。方法90例行甲狀腺切除手術(shù)患者,按照隨機(jī)數(shù)字表法分為對照組與觀察組,各45例。兩組患者均采用頸叢神經(jīng)阻滯麻醉;對照組輔助泵注咪達(dá)唑侖;觀察組輔以泵注右美托咪定。于不同時間點(diǎn)觀察兩組患者血液流動力學(xué)(MAP、HR、SpO2)變化,分別采用Ramsay評分及視覺模擬評分(VAS)評價兩組患者鎮(zhèn)靜、鎮(zhèn)痛效果,統(tǒng)計不良反應(yīng)情況。結(jié)果觀察組不同時間點(diǎn)各項(xiàng)血液流動力學(xué)指標(biāo)水平比較,差異無統(tǒng)計學(xué)意義(P0.05);對照組不同時間點(diǎn)各項(xiàng)血液流動力學(xué)指標(biāo)比較,差異具有統(tǒng)計學(xué)意義(P0.05);且于切皮即刻、處理甲狀腺上極時MAP及HR明顯高于觀察組,差異具有統(tǒng)計學(xué)意義(P0.05)。觀察組于分離甲狀腺上極及縫皮時Ramsay評分得分明顯高于對照組,而VAS評分明顯低于對照組,差異具有統(tǒng)計學(xué)意義(P0.05)。觀察組各項(xiàng)不良反應(yīng)發(fā)生率明顯低于對照組,差異具有統(tǒng)計學(xué)意義(P0.05)。結(jié)論于甲狀腺切除手術(shù)中應(yīng)用右美托咪定輔助頸叢神經(jīng)阻滯可有利于維持患者血液流動力學(xué)穩(wěn)定,同時還具有較好的鎮(zhèn)靜、鎮(zhèn)痛效果,降低不良反應(yīng)發(fā)生,值得臨床推廣應(yīng)用。
[Abstract]:Objective to investigate the effect of dexmetomidine on cervical plexus block during thyroidectomy anesthesia, and to observe its effect on hemodynamics. According to the method of random number table, the patients were divided into control group (n = 45) and observation group (n = 45). The patients in both groups were anesthetized by cervical plexus nerve block, and midazolam was injected into the control group. The patients in the observation group were injected with dexmetomidine. The changes of blood flow mechanics MAPHR-SpO2 were observed at different time points, and the sedative and analgesic effects of the two groups were evaluated by Ramsay score and visual analogue score respectively. Results there was no significant difference in the levels of blood flow mechanics at different time points in the observation group, and there was no significant difference between the two groups (P 0.05), while in the control group, the indexes of blood flow mechanics at different time points were compared. The difference was statistically significant (P 0.05), and the MAP and HR were significantly higher in the treatment of thyroid superior pole than in the observation group (P 0.05). The Ramsay score of the observation group was significantly higher than that of the control group in separating the superior thyroid pole and the suture skin. The VAS score was significantly lower than that in the control group, and the difference was statistically significant (P 0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group. Conclusion the application of dexmetomidine in cervical plexus block during thyroidectomy is beneficial to maintain the stability of blood flow mechanics, and has good sedative and analgesic effects. Reduce the occurrence of adverse reactions, worthy of clinical application.
【作者單位】： 紹興文理學(xué)院附屬醫(yī)院麻醉科;
【分類號】：R614

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