CAJ | 학술논문

目的：探讨连续波针刺辅助麻醉(针麻)在甲状腺手术患者中的应用效果。方法选择120例甲状腺切除手术患者,按麻醉方式(依患者意愿选择)分为3组,每组40例。 A组采用针麻+局麻,B组采用颈丛阻滞,C组采用针麻+颈丛阻滞,分别记录3组在麻醉前、诱导后切皮前、术中分离甲状腺上下极、术毕4个时点的血压、心率、脉搏氧饱和度( SpO2)的变化,并评价镇痛效果,记录术中辅助用药及术后并发症发生情况。结果在分离甲状腺上下极时,B组血压、心率较麻醉前显著升高(P<0．05),与A、C两组比较差异亦有统计学意义(P<0．05),其余时点3组血压、心率变化不明显(P>0．05)；3组各时点SpO2比较差异均无统计学意义(P>0．05)。 A、C组镇痛效果显著优于B组(P<0．05)。 B组术中芬太尼用量显著高于A、C组(P<0．05)。术后B组并发症发生率显著高于A、C两组(P<0．05)。结论针麻联合局麻或颈丛阻滞用于甲状腺手术具有止痛完全、对循环影响小、用药量少、并发症少等优点,是甲状腺手术较安全有效的麻醉方法。
목적：탐토련속파침자보조마취(침마)재갑상선수술환자중적응용효과。방법선택120례갑상선절제수술환자,안마취방식(의환자의원선택)분위3조,매조40례。 A조채용침마+국마,B조채용경총조체,C조채용침마+경총조체,분별기록3조재마취전、유도후절피전、술중분리갑상선상하겁、술필4개시점적혈압、심솔、맥박양포화도( SpO2)적변화,병평개진통효과,기록술중보조용약급술후병발증발생정황。결과재분리갑상선상하겁시,B조혈압、심솔교마취전현저승고(P<0．05),여A、C량조비교차이역유통계학의의(P<0．05),기여시점3조혈압、심솔변화불명현(P>0．05)；3조각시점SpO2비교차이균무통계학의의(P>0．05)。 A、C조진통효과현저우우B조(P<0．05)。 B조술중분태니용량현저고우A、C조(P<0．05)。술후B조병발증발생솔현저고우A、C량조(P<0．05)。결론침마연합국마혹경총조체용우갑상선수술구유지통완전、대순배영향소、용약량소、병발증소등우점,시갑상선수술교안전유효적마취방법。
Objective To investigate the effect of continuous wave acupuncture as auxiliary anesthesia for pa-tients undergoing thyroid surgery. Methods A total of 120 patients undergoing thyroid surgery were divided into group A (n=40, acupuncture anesthesia), group B (n=40, cervical plexus block) and (n=40, acupuncture anesthesia +cervical plexus block) according to the anesthesia methods ( patients' choice) . The changes of blood pressure, heart rate and pulse oxygen saturation ( SpO2 ) in the three groups were respectively recorded before anesthesia, before cutting skin after induction, intraoperative separation of upper and lower thyroid poles, and at the end of the surgery, and the analge-sia effect was also evaluated. The uses of intraoperative adjuvant drug and incidence rates of postoperative complications were also recorded. Results In the intraoperative separation of upper and lower thyroid poles, the levels of blood pres-sure and heart rate were significantly higher than those before the anesthesia in group B (P<0. 05), and the differences in the levels were statistically significant compared with those in group A and C ( P<0. 05 ) , but the differences in the levels were not statistically significant in the other three points among the three groups (P>0. 05);there were no signifi-cant differences in SpO2 levels among the three groups at all time points ( P>0. 05 ) . The analgesic effects in group A and C were significantly better than that in group B (P<0. 05). Intraoperative Fentanyl dosage in group B was signifi-cantly higher than those in group A and C (P<0. 05). The incidence rate of postoperative complications in group B was significantly higher than those in group A and C (P<0. 05). Conclusion Acupuncture analgesia combined with local anesthesia or cervical plexus block in thyroid surgery has advantages such as complete analgesia, little effect on circula-tion, small dosage and lower incidence rate of complications.