泵注瑞芬太尼及异丙酚维持麻醉对甲状腺切除患者麻醉的临床效果

Clinical Research of the Anesthesia Effect of Remifentanil Combine Propofol for Resection of Thyroid Gland Operation Anesthesia

目的观察瑞芬太尼及异丙酚联合麻醉对甲状腺切除患者的临床麻醉效果。方法本试验自制定方案日起,严格选择受试者,选择2010年3月至2011年3月在我院接受甲状腺手术患者100例,纳入研究的受试人群,将患者以完全等量随机的科学研究方法分为观察组(n=50例)及对照组(n=50例)。对照组采用静脉泵注异丙酚及芬太尼间断推注麻醉。观察组予异丙酚、瑞芬太尼持续静脉泵注维持麻醉。监测患者术前及术后的心率及平均动脉压等血流动力学的变化,记录患者手术后拔除插管以及开始自主呼吸的时间以及术后患者steward的得分情况,并详细记录刺激性咳嗽及躁动不安等不良反应发生的程度及人次。结果插管、拔管及拔管10min时2组患者的自主呼吸恢复时间、拔管时间、steward评分比较具有统计学意义(P<0.05);对照组患者出现刺激性咳嗽以及躁动不安等不良反应的人数要明显多于观察组患者发生率要明显多于对照组患者(P<0.05)。结论泵注瑞芬太尼及异丙酚维持麻醉用于甲状腺手术患者具有稳定患者血流动力学,缩短苏醒时间,减少不良反应的发生等效果。

Objective To analyze the anesthesia effect of remifentanil combine propofol for resection of thyroid gland operation anesthesia. Methods 100 cases were randomly divided into two groups,50 cases in each group,two gorups of patients were given tracheal intubation general anesthesia. The observation group was treated with continuous intravenous infusino of remifentanil and propofol. The control group using continuous intravenous infusion of propofol and fentanyl anesthesia maintained by intermittent bolus injiction. Hemodynamic changes in patients after operation for spontanesous breathing, recovery time, waking time, calling the goggle time, extubation time,steward score of recovery and the recovery period the incidence of adverse reactions of the two groups were observed and compared. Results MAP,HR during intubation, tube drawing, extubation after 5 min,respiratory recovery time, calling the goggle time, waking time, extubation time and steward score of recovery between two groups were significant different（P〈0. 05）;the restlessness, cough reflex and other undesirable reaction rate in the observation group was lower than that in the control group, there was statistically significant different（P〈0. 05）. Conclusion Remifentanil combined with propofol for thyroid resection operation of anesthesia, intraoperative hemodynamic stability, recovery time is significantly shorter, has good effect and a low incidence of adverse reactions.