穴位注射麻醉用于甲状腺手术61例临床观察

摘要

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.%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.