舒芬太尼联合瑞芬太尼在高频超声刀甲状腺手术中的应用

发布时间：2018-01-18 10:12

本文关键词：舒芬太尼联合瑞芬太尼在高频超声刀甲状腺手术中的应用　出处：《广东医学》2017年14期 　论文类型：期刊论文

【摘要】：目的探讨舒芬太尼联合瑞芬太尼应用于高频超声刀甲状腺手术中的安全性和有效性。方法选取接受高频超声刀甲状腺手术治疗的患者共230例,随机分为舒芬太尼联合瑞芬太尼麻醉组(SR组)及单纯瑞芬太尼麻醉组(R组)。观察两组患者围术期生命体征指标的变化,分别记录记录诱导前(T0)、插管前(T1)、插管时(T2)、手术中(T3)以及拔管后(T4)的生命体征指标,以及拔管后镇静评分(The Observer's Assessment of Alertness/Sedation Scale,OAA/S)、疼痛评分(VAS)、躁动评分。结果两组患者T4时间点SBP和HR均显著高于T0时,且SR组患者在T1~T3时的SBP水平、在T2、T3时的HR水平显著优于R组,差异有统计学意义(P0.05)。拔管后即刻SR组患者的疼痛程度评分显著低于R组,差异有统计学意义(Z=6.354,P0.05);拔管10 min后,SR组患者的OAA/S、VAS以及躁动评分显著低于R组,差异有统计学意义(P0.05)。R组出室时血压、SpO_2和RR值显著升高且高于SR组,差异有统计学意义(P0.05)。结论舒芬太尼联合瑞芬太尼应用于高频超声刀甲状腺手术中,能够较好地控制血压,减轻拔管后疼痛程度,具有较好的安全性和有效性,值得一步推广研究。
[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.
【作者单位】：上海交通大学医学院附属瑞金医院古北分院麻醉科;上海交通大学医学院附属瑞金医院麻醉科;
【分类号】：R614
【正文快照】： (上海200025)高频超声刀[1]应用于甲状腺手术能够显著缩短手术时间,减少出血量,缩小手术创口,改善预后,广泛应用于临床。但超声刀的使用增加了手术的刺激程度,扩大了患者的应激反应。甲状腺肿瘤[2]是多发于女性头颈部的能够显著影响吞咽、呼吸功能的肿瘤,患者的年龄与恶性程度

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