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目的对舒芬太尼超前镇痛联合颈丛神经阻滞在甲状腺瘤切除术中的临床效果及安全性进行探究。方法 120例接受甲状腺瘤切除术治疗的患者为研究对象,依据麻醉方式的不同分为A组(单纯颈丛神经阻滞)、B组(舒芬太尼术中应用联合颈丛神经阻滞)以及C组(舒芬太尼超前镇痛联合颈丛神经阻滞),各40例。对三组患者的麻醉效果、Ramsay镇静评分进行对比,观察比较三组颈丛阻滞前(Tl)、切皮后5 min(T2)、剥离瘤体时(T3)、术毕时(T4)的平均动脉压(MAP)、心率(HR)、血氧饱和度(Sp O2)差异。结果 A、B、C组麻醉优良率分别为75.0%、80.0%、100.0%,C组优良率明显优于A组、B组,差异均具有统计学意义(P<0.05);A、B两组对比,差异无统计学意义(P>0.05)。C组Ramsay评分效果明显优于A组、B组,差异均具有统计学意义(P<0.05);A、B两组对比,差异无统计学意义(P>0.05)。C组T2、T3、T4时的HR及MAP均优于A组、B组,差异均具有统计学意义(P<0.05);A、B两组对比,差异无统计学意义(P>0.05)。三组SpO_2变化不明显,组间比较差异无统计学意义(P>0.05)。结论对于行甲状腺瘤切除术的患者采取舒芬太尼超前镇痛联合颈丛神经阻滞能够有效提升患者麻醉效果,提升手术安全性与舒适度,值得推广。
Objective To investigate the clinical efficacy and safety of sufentanil combined with advanced cervical pain and cervical plexus block in thyroidectomy. Methods One hundred and twenty patients undergoing thyroidectomy were divided into group A (simple cervical plexus block) and group B (sufentanil combined with cervical plexus block) according to the mode of anesthesia. And C group (Sufentanil advanced analgesia combined with cervical plexus block), each 40 cases. The anesthetic effects and the sedation scores of Ramsay were compared among the three groups. The levels of Tl, T 2, T 2, T 3, T 4, Mean arterial pressure (MAP), heart rate (HR), oxygen saturation (Sp O2) differences. Results The excellent and good rates of anesthesia in group A, B and C were 75.0%, 80.0% and 100.0%, respectively. The excellent and good rates in group C were significantly better than those in group A and B (P <0.05) There was no significant difference between the two groups (P> 0.05). The Ramsay score of group C was significantly better than that of group A and group B (P <0.05). There was no significant difference between group A and group B (P> 0.05). The HR and MAP of group C at T2, T3 and T4 were better than those of group A and group B (P <0.05). There was no significant difference between group A and group B (P> 0.05) . Three groups of SpO_2 change was not obvious, no significant difference between groups (P> 0.05). Conclusion For patients with thyroidectomy, advanced sufentanil combined with cervical plexus block can effectively improve anesthesia and safety and comfort of the patients, which is worthy of popularization.