不同频率针刺辅助麻醉对甲状腺手术应激反应的影响.doc

不同频率针刺辅助麻醉对甲状腺手术应激反应的影响 马武华 黎玉辉 高晓秋 罗艳霞 陈鸶 王心田 温科辉 [摘要]目的方法例患者随机分为组μg/kg，镇痛效果采用世界卫生组织疼痛程度评级标准进行评定。比较各组患者在基础状态下（t0）、入室诱导前（t1）、阻滞后15min（t2）、切皮前消毒时（t3）、切皮时（t4）、阻滞后30min（t5）、牵拉甲状腺时（t6）、阻滞后1h（t7）、阻滞后2h（t8）、术毕（t9）这9个时间点心率、血压的变化以及术中辅助用药情况和镇痛效果；同时在麻醉前（T1）、诱导后切皮前（T2）、术中分离甲状腺上极（T3）、术毕（T4）分别采取外周静脉血检测血液中皮质醇（Cor）结果：P＜0.05）P＜0.05P＜0.05P＜0.05P＜0.05P＜0.05）P＜0.0P＜0.05）P＜0.05）P＜0.05）结论system stress reaction during thyroid surgery MA Wu-hua,LI Yu-hui,GAO Xiao-qiu,et al. Department of Anesthesiology,First Affiliated Hospital,Guangzhou University of Traditional Chinese Medicine,Guangzhou,510405 China [Abstract] Objectives To investigate the effects of acupuncture-assisted anesthesia with Different frequencies disperse-dense waves on cortisone,β-endorphin during thyroid surgery Methods 60 patients undergoing elective thyroidectomy ,ASA I～II,were divided randomly into three groups.In Group A,20 patients received CPB plus a low-high mixed-frequency (2/100Hz) TENS in the bilateral Hegu and Neiguan acupionts ;In group B, 20 patients received CPB plus low-middle mixed-frequency (2/15Hz) TENS, In group C, 20 patients receive CPB plus sham TENS (as a controlled group). CPB was performed after TENS administered 15 minutes. analgesic effect was assessed through the standard about degree of pain by world health organization (WHO). Blood pressure (SBP/DBP), heart rate(HR)and the additional drugs were recorded at 9 time points (baseline t1，before the anesthesia t2,15 minutes after CPB t3，skin incision t4，30 minutes after CPB t5, maximum operative trauma t6，1h after CPB t7, 2hrs after CPB t8, end of surgery t9).at the same time ,the venous blood samples were taken for measurements of cortisone(Cor),β-endorphin（β-EP）before the anesthesia ,before the skin incision， maximumoperative trauma and the end of surgery. Complications and toxic side effects were documened during perioperation period．Statistical analysis was performed with SPSS12.0 sofrware .All the quantitative data of t