针刺麻醉复合小剂量瑞芬太尼用于甲状腺良性结节消融术的临床疗效观察

Observation on the Effect of Combined Anesthesia of Acupuncture and Low-dose Remifentanil on the Microwave Ablation for Patient with Benign Thyroid Nodules

目的:探讨小剂量瑞芬太尼复合针刺麻醉在甲状腺良性结节消融术中的麻醉镇痛效果。方法:选取2015年6月至2016年6月在我院进行甲状腺良性结节射频消融术的患者71例,并将其随机分为对照组(n=35)和复合麻醉组(n=36)。对照组患者接受单纯芬太尼麻醉,复合麻醉组患者接受小剂量瑞芬太尼复合针刺麻醉,观察和比较两组患者麻醉前(T0)、麻醉后(T1)、消融术中(T2)、手术结束(T3)时患者的平均动脉压(MAP)、心率(HR)、血氧饱和度(HPO_2)和VAS评分。结果:复合麻醉组患者T2和T3时间点MAP(95.00±6.09,90.86±3.23)(P<0.05)、HR值(65.19±3.52,75.03±6.00)均显著低于对照组(P<0.05),HPO_2水平(98.78±1.15,97.81±1.47)均显著高于对照组(P<0.05),VAS评分(3.25±1.38,1.69±1.43)均显著低于对照组(P<0.05)。结论:电针刺激结合小剂量瑞芬太尼复合麻醉用于甲状腺良性结节消融术可有效镇痛并维持较稳定的血压和心率,效果明显优于单纯芬太尼麻醉。

Objective： To investigate the analgesic effect of combined anesthesia of acupuncture and low-dose remifentanil in microwave ablation for patient with benign thyroid nodules.Methods： Seventy-one benign thyroid nodules patients receiving microwave ablation from July 2015 to July 2016 were randomly assigned to the control group and the combined anesthesia group.Patients in the control group received Fentanyl anesthesia,while patients in the combined anesthesia group received combined anesthesia of acupuncture and low-dose Remifentanil during microwave ablation.The MAP,HR,HPO2 and VAS scores were recorded and compared between two groups before anesthesia（T0）,after anesthesia（T1）,during ablation（T2） and at the end of ablation（T3）.Results： Compared with the control group,the MAP（95.00±6.09,90.86±3.23） and HR（65.19±3.52,75.03±6.00） were significantly lower in the combined anesthesia group at T2 and T3（P〈0.05）,the HPO2（98.78±1.15,97.81±1.47） were significantly lower in the combined anesthesia group（P〈0.05）,and the VAS（3.25±1.38,1.69±1.43） scores were significantly lower in the combined anesthesia group（P〈0.05）.Conclusion： Combined anesthesia of acupuncture and low-dose Remifentanil had an effective analgesic action with stable blood pressure and heart rate,which was better than fentanyl.