摘要
目的:研究盐酸罗哌卡因膨胀液在腔镜甲状腺切除术中的应用及对患者血清皮质醇(Cor)、强啡肽(DYN)水平的影响。方法:选择本院2015年1月-2020年1月诊治的68例甲状腺结节患者作为研究对象,均在本院进行腔镜甲状腺切除术,随机数字表法均分为对照组和研究组,各34例,前者采用生理盐水膨胀液作为手术膨胀介质,后者采用盐酸罗哌卡因膨胀液作为手术膨胀介质。比较两组患者手术前后应激反应、疼痛介质水平和疼痛评分。结果:术前两组患者Cor、去甲肾上腺素(NE)、肾上腺素(E)、DYN、β-内啡肽(β-EP)和一氧化氮(NO)比较无统计学意义(P>0.05),术后研究组上述指标水平均明显低于对照组(P<0.05);与对照组相比,研究组患者不同时间点视觉模拟(VAS)评分、Ramsay评分均明显降低(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05)。结论:盐酸罗哌卡因膨胀液应用于腔镜甲状腺切除术中,可减少患者Cor、DYN水平升高,减轻机体应激反应和术后疼痛,且不增加患者不良反应。
Objective:To investigate the use of ropivacaine hydrochloride as inflation fluid in endoscopic thyroidectomy and its effects on serum levels of cortisol(Cor)and dynorphin(DYN).Methods:Sixty-eight patients with thyroid nodules diagnosed and treated in our hospital between January 2015 and January 2020 were enrolled as subjects.All patients underwent endoscopic thyroidectomy in our hospital,assigned to the control group and study group according to random number table(n=34 each).The inflation fluid at surgery was normal saline in the control group and ropivacaine hydrochloride in the study group.The stress response,pain mediators and pain scores were compared between the two groups before and after surgery.Results:Before surgery,there were no statistically significant differences in Cor,norepinephrine(NE),epinephrine(E),DYN,β-endorphin(β-EP)and nitric oxide(NO)levels(P>0.05).After surgery,these indexes were significantly lower in the study group than those in the control group(P<0.05).Compared with the control group,the visual analog score(VAS)and Ramsay score at different time points were lower in the study group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Ropivacaine hydrochloride used as inflation fluid in endoscopic thyroidectomy may lead to less elevation in Cor and DYN levels,milder stress response and postoperative pain,meanwhile without increase in adverse reactions.
作者
詹尚欣
古旭莹
江水华
陈锭光
张琳
Zhan Shangxin;Gu Xuying;Jiang Shuihua;Chen Dingguang;Zhang Lin(Second Division,Department of General Surgery,Huizhou Hospital of Traditional Chinese Medicine,Huizhou 516000,Guangdong,China)
出处
《广州医科大学学报》
2020年第3期11-14,共4页
Academic Journal of Guangzhou Medical University
