本文關(guān)鍵詞：舒芬太尼聯(lián)合瑞芬太尼在高頻超聲刀甲狀腺手術(shù)中的應(yīng)用　出處：《廣東醫(yī)學(xué)》2017年14期 　論文類型：期刊論文

  更多相關(guān)文章： 舒芬太尼 瑞芬太尼 高頻超聲 甲狀腺手術(shù)

【摘要】：目的探討舒芬太尼聯(lián)合瑞芬太尼應(yīng)用于高頻超聲刀甲狀腺手術(shù)中的安全性和有效性。方法選取接受高頻超聲刀甲狀腺手術(shù)治療的患者共230例,隨機(jī)分為舒芬太尼聯(lián)合瑞芬太尼麻醉組(SR組)及單純?nèi)鸱姨崧樽斫M(R組)。觀察兩組患者圍術(shù)期生命體征指標(biāo)的變化,分別記錄記錄誘導(dǎo)前(T0)、插管前(T1)、插管時(shí)(T2)、手術(shù)中(T3)以及拔管后(T4)的生命體征指標(biāo),以及拔管后鎮(zhèn)靜評(píng)分(The Observer's Assessment of Alertness/Sedation Scale,OAA/S)、疼痛評(píng)分(VAS)、躁動(dòng)評(píng)分。結(jié)果兩組患者T4時(shí)間點(diǎn)SBP和HR均顯著高于T0時(shí),且SR組患者在T1~T3時(shí)的SBP水平、在T2、T3時(shí)的HR水平顯著優(yōu)于R組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。拔管后即刻SR組患者的疼痛程度評(píng)分顯著低于R組,差異有統(tǒng)計(jì)學(xué)意義(Z=6.354,P0.05);拔管10 min后,SR組患者的OAA/S、VAS以及躁動(dòng)評(píng)分顯著低于R組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。R組出室時(shí)血壓、SpO_2和RR值顯著升高且高于SR組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論舒芬太尼聯(lián)合瑞芬太尼應(yīng)用于高頻超聲刀甲狀腺手術(shù)中,能夠較好地控制血壓,減輕拔管后疼痛程度,具有較好的安全性和有效性,值得一步推廣研究。
[Abstract]:Objective to investigate the safety and efficacy of sufentanil combined with remifentanil in thyroid surgery with high frequency ultrasound knife. The patients were randomly divided into sufentanil combined remifentanil anesthesia group (SR group) and remifentanil anesthesia group (group R). Vital signs of T1 before intubation, T2 during intubation, T3 during operation and T4 after extubation. And sedation score after extubation and the Observer's Assessment of Alertness/Sedation Scale. Results the SBP and HR at T4 time point were significantly higher than those at T0, and the SBP level of SR group was higher than that of T1T 3 group. The HR level at T _ 2 T _ 3 was significantly higher than that in R group (P 0.05). The pain score of SR group was significantly lower than that of R group immediately after extubation. The difference was statistically significant (P 0.05). After extubation for 10 min, the OAA / Sch VAS and restlessness scores in SR group were significantly lower than those in R group (P < 0.05). The values of SpO_2 and RR in SR group were significantly higher than those in SR group (P 0.05). Conclusion Sufentanil combined with remifentanil is used in thyroid surgery with high frequency ultrasound knife. It can control blood pressure and relieve pain after extubation. It is safe and effective. It is worth popularizing research.
【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬瑞金醫(yī)院古北分院麻醉科;上海交通大學(xué)醫(yī)學(xué)院附屬瑞金醫(yī)院麻醉科;
【分類號(hào)】：R614
【正文快照】： (上海200025)高頻超聲刀[1]應(yīng)用于甲狀腺手術(shù)能夠顯著縮短手術(shù)時(shí)間,減少出血量,縮小手術(shù)創(chuàng)口,改善預(yù)后,廣泛應(yīng)用于臨床。但超聲刀的使用增加了手術(shù)的刺激程度,擴(kuò)大了患者的應(yīng)激反應(yīng)。甲狀腺腫瘤[2]是多發(fā)于女性頭頸部的能夠顯著影響吞咽、呼吸功能的腫瘤,患者的年齡與惡性程度

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