静脉泵注异丙酚及芬太尼间断推注麻醉对甲状腺切除患者血流动力学的影响

摘要

OBJECTIVE:To explore the effects of intravenous-infusion of propofol and discontinuous intravenous-infusion anesthesia of fentanyl on hemodynamics of patients undergoing thyroidectomy . METHODS: 92 patients undergoing thyroidectomy admitted into the hospital from Nov .2011 to Nov.2014 were selected as the research objects.According to the mode of anesthesia , the patients were divided into control group and observation group .46 patients in control group received bilateral anterior cervical plexus block anesthesia while the other 46 patients in observation group received intravenous infusion anesthesia of propofol and fentanyl .The changes of hemodynamics in two group of patients were observed .The occurrence probabilities of restlessness and cough in two group of patients during the period of awakening were recorded .RESULTS: The hemodynamic stability of the observation group was significantly better than that in the control group , the difference was statistically significant ( P <0.05 ) . The occurrence probabilities of restlessness and cough in the observation group were [ 10.87%( 5/46 ) ] and [ 4.35%(2/46)], which were significantly lower than that in the control group [28.26%(13/46)]and [17.39%(8/46)], the difference was statistically significant ( P <0.05 ) . CONCLUSIONS: Intravenous-infusion of propofol and discontinuous intravenous-infusion anesthesia of fentanyl can reduce the effects on hemodynamics of patients undergoing thyroidectomy , improve the security of operation .It is worthy of clinical promotion .%目的：探讨静脉泵注异丙酚及芬太尼间断推注麻醉对甲状腺切除患者血流动力学的影响。方法：选取2012年11月—2014年11月行甲状腺切除手术的患者92例作为研究对象，按随机数字表法将患者分对照组和观察组各46例，对照组患者行双侧颈前丛神经阻滞麻醉，观察组患者行静脉泵注异丙酚及芬太尼间断推注麻醉，观察2组患者的血流动力学变化情况，并记录2组患者的苏醒期躁动及咳嗽的发生情况。结果：观察组患者的血流动力学稳定性显著优于对照组，差异有统计学意义（P＜0.05）；观察组苏醒期躁动、咳嗽的发生率为10.87％（5／46）、4.35％（2／46），均显著低于对照组的28.26％（13／46）、17.39％（8／46），差异均有统计学意义（P＜0.05）。结论：静脉泵注异丙酚及芬太尼间断推注麻醉可减少对甲状腺切除术患者血流动力学的影响，提高手术安全性，值得临床推广。