穴位内注射麻醉联合颈丛阻滞应用于甲状腺手术的疗效观察

Application of Acupoint-Injection Anesthesia Combined with Cervical Plexus Block in Thyroidectomy

目的观察穴位内注射麻醉联合颈丛阻滞麻醉应用于甲状腺手术的疗效。方法选择ASAⅠ～Ⅱ拟行甲状腺手术的患者120例,随机分为3组,A组为单纯颈丛阻滞麻醉;B组为穴位内注射生理盐水联合颈丛阻滞麻醉;C组为穴位内注射麻醉联合颈丛阻滞麻醉。术中连续监测MAP,HR和SPO_2,分别于麻醉前,游离瘤体或甲状腺时术中及术终测血糖浓度,并评价麻醉效果。结果3组在剥离瘤体或甲状腺时,MAP、HR均明显高于术前,但C组增高的程度明显低于A组和B组。3组手术前后SPO_2的变化差别无统计学意义。3组术中血糖水平与术前相比均增高(P<0.05),但C组升高幅度低于A组和B组(P<0.05),A、B两组间比较差别无统计学意义(P>0.05),C组麻醉效果(优良率93%)好于A组(优良率70%)和B组(优良率75%),A、B两组麻醉效果比较差别无统计学意义。结论甲状腺手术中,穴位内注射联合颈丛阻滞麻醉不仅效果可靠,术中生命体征平稳,并降低应激反应。

Objective To observe application of acupoint-injection anesthesia combined with cervical plexus block in thyroidectomy. Methods One hundred and twenty ASA I -II patients performing thyroidectomy were randomized into three groups, group A （40 cases ） , using cervical plexus block, group B （ 40 cases ） , using acupoint-injection NS combined with cervical plexus block, group C （40 cases ） , using acupoint-injection dolantin combined with cervical plexus block. The patients in group A accepted cervical plexus block , then dolantin was administered as an intramuscular injection. The patients in group B accepted acupuncture bilateral Hegn except cervical plexus block ,upon needling sensation was produced, NS was injected into the point, then dolantin was administered as an intramuscular injection. The patients in group C accepted acupuncture bilateral Hegu combined with cervical plexus block, upon needling sensation was produced, dolantin was injected into the point. During operation, MAP, HR, SPO2 were continuously monitored, blood glucose was sampled,anesthesia effect was evaluated. Results MAP and HR in three groups were significantly increased when lump or thyroid gland was stripped. Compared with group A and group B, the range of increase in group C is significantly less. The level of blood glucose in 3 groups is higher during operation than pre-operation. Increase in group C is lower than group A and group B. Additionallyianesthesia effect in group C is better than group A and group B. Conclusion The effect of acupoint-injection anesthesia combined with cervical plexus block is reliable. Vital sign is stable. Moreovertstress reaction is depressed.