国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2009年
9期
41-43
,共3页
潘林英%阎玉兰%张黛娟%钟育梅%何玖科%吴传满%曾晓军%邓娇莲%涂仙凤%TU Xian-feng
潘林英%閻玉蘭%張黛娟%鐘育梅%何玖科%吳傳滿%曾曉軍%鄧嬌蓮%塗仙鳳%TU Xian-feng
반림영%염옥란%장대연%종육매%하구과%오전만%증효군%산교련%도선봉%TU Xian-feng
穴位注射麻醉%颈丛阻滞%甲状腺手术
穴位註射痳醉%頸叢阻滯%甲狀腺手術
혈위주사마취%경총조체%갑상선수술
Point-injection anesthesia%Cervial plexum block%Thyroid operation
目的 评价穴位注射麻醉用于甲状腺手术的麻醉效果.方法 将123例甲状腺疾病需手术治疗的患者随机分为两组:试验组61例,为穴位注射麻醉组;对照组62例,为颈丛阻滞麻醉组.分别比较两组麻醉起效时间,注药后30分钟VRS(verbal rating scales)评级,术前收缩压、舒张压、心率,手术开始收缩压、舒张压、心率,术毕收缩压、舒张压、心率,术中术后恶心呕吐发生率、术后并发症(膈神经麻痹、喉返神经麻痹、霍纳氏综合症)发生率各项指标的差异.结果 试验组和对照组对比,麻醉起效时间无显著性差异(P=0.64),注药后30分钟VRS评级无显著性差异(P=0.87),术前收缩压、舒张压及心率无显著性差异(P值分别为0.65、0.48、0.47),手术开始及术毕收缩压、舒张压及心率,试验组均低于对照组(P值均小于0.01),术中、术后恶心呕吐发生率,两组比较,无显著性差异(P=0.26),术后膈神经麻痹、喉返神经麻痹、霍纳氏综合症(Hornor syndrome)等发生率试验组明显低于对照组(p=0.02).结论 穴位注射麻醉用于甲状腺手术可以起到与颈丛阻滞麻醉同样的效果,并发症发生率低,适合在基层医院开展.
目的 評價穴位註射痳醉用于甲狀腺手術的痳醉效果.方法 將123例甲狀腺疾病需手術治療的患者隨機分為兩組:試驗組61例,為穴位註射痳醉組;對照組62例,為頸叢阻滯痳醉組.分彆比較兩組痳醉起效時間,註藥後30分鐘VRS(verbal rating scales)評級,術前收縮壓、舒張壓、心率,手術開始收縮壓、舒張壓、心率,術畢收縮壓、舒張壓、心率,術中術後噁心嘔吐髮生率、術後併髮癥(膈神經痳痺、喉返神經痳痺、霍納氏綜閤癥)髮生率各項指標的差異.結果 試驗組和對照組對比,痳醉起效時間無顯著性差異(P=0.64),註藥後30分鐘VRS評級無顯著性差異(P=0.87),術前收縮壓、舒張壓及心率無顯著性差異(P值分彆為0.65、0.48、0.47),手術開始及術畢收縮壓、舒張壓及心率,試驗組均低于對照組(P值均小于0.01),術中、術後噁心嘔吐髮生率,兩組比較,無顯著性差異(P=0.26),術後膈神經痳痺、喉返神經痳痺、霍納氏綜閤癥(Hornor syndrome)等髮生率試驗組明顯低于對照組(p=0.02).結論 穴位註射痳醉用于甲狀腺手術可以起到與頸叢阻滯痳醉同樣的效果,併髮癥髮生率低,適閤在基層醫院開展.
목적 평개혈위주사마취용우갑상선수술적마취효과.방법 장123례갑상선질병수수술치료적환자수궤분위량조:시험조61례,위혈위주사마취조;대조조62례,위경총조체마취조.분별비교량조마취기효시간,주약후30분종VRS(verbal rating scales)평급,술전수축압、서장압、심솔,수술개시수축압、서장압、심솔,술필수축압、서장압、심솔,술중술후악심구토발생솔、술후병발증(격신경마비、후반신경마비、곽납씨종합증)발생솔각항지표적차이.결과 시험조화대조조대비,마취기효시간무현저성차이(P=0.64),주약후30분종VRS평급무현저성차이(P=0.87),술전수축압、서장압급심솔무현저성차이(P치분별위0.65、0.48、0.47),수술개시급술필수축압、서장압급심솔,시험조균저우대조조(P치균소우0.01),술중、술후악심구토발생솔,량조비교,무현저성차이(P=0.26),술후격신경마비、후반신경마비、곽납씨종합증(Hornor syndrome)등발생솔시험조명현저우대조조(p=0.02).결론 혈위주사마취용우갑상선수술가이기도여경총조체마취동양적효과,병발증발생솔저,괄합재기층의원개전.
Objective To evaluate the therapeutic effect of point-injection anesthesia for thyroid operation. Methods 123 patients with thyroid diseases requiring treatment by surgery were randomly allocated to two groups: the experimental group included 61 cases who were anesthetized by point-injection; the control group included 62 cases who were anesthetized by cervial plexum block. Differences in onset time of anesthesia, VRS evaluated 30 minutes after injection, the SBP, DBP, HR before opreration, the SBP, DBP, HR at the beginning of the operation, the SBP, DBP, HR at the end of the operation, the incidence of nausea and vomiting during and post operation, the incidence of the complications(diaphragmatic paralysis, recurrent laryngeal nerve paralysis and Hornor syndrome) post operation were assessed between two groups. Results For the onset time of anesthesia, VRS evaluated 30 minutes after injection and the SBP, DBP, HR before operation, the differences were not statistically significant between the two groups (P=0.64, 0.87, 0.65, 0.48, 0.47 respectively).At the beginning and end of the operation, the SBP, DBP, HR decreased in the experimental group compared with the control (P <0.01). For the incidence of nausea and vomiting during and post operation, no significance was observed between the two groups(P=0.26). The incidence of diaphragmatic paralysis, recurrent laryngeal nerve paralysis and Hornor syndrome post operation decreased in the experimental group compared with the control. Conclusion Point-injection anesthesia, the complications incidence of which is lower, is as effective as eervial plexum block, and it is suitable for the grass-roots hospitals.