甲状腺手术超声引导下行星状神经节阻滞的效果

Effect of Ultrasound-guided Stellate Ganglion Block in Thyroid Surgery

摘要:

〔摘 要〕 目的：研究甲状腺手术患者术前在超声引导下实施星状神经节阻滞（SGB）干预对手术效果及头痛、恶心 呕吐情况的影响。方法：选取南平市第一医院 2021 年 3 月至 2022 年 3 月收治的 80 例行甲状腺手术患者，依据随机 数字表法分为对照组（40 例）与观察组（40 例），两组患者均接受气管插管全身麻醉，对照组术前采取盲探法行 SGB 干预，，观察组术前在超声引导下实施 SGB 干预，观察并比较两组患者各项麻醉相关指标。结果：观察组患者 的麻醉起效时间短于对照组，差异具有统计学意义（P ＜ 0.05）；两组患者的麻醉维持时间比较，差异无统计学意义 （P ＞ 0.05）。观察组患者的术后 24 h 恶心呕吐风险价值评分法（VAR）评分为（0.12 ± 0.03）分，低于对照组的 （0.35 ± 0.08）分，差异具有统计学意义（P ＜ 0.05）。术后 24 h 内观察组患者的呕吐发生率为 5.00 %，低于对照 组的 22.50 %，差异具有统计学意义（P ＜ 0.05）。术后 6 h、12 h、24 h、48 h，两组患者的头痛发生率比较，差异 无统计学意义（P ＞ 0.05）。观察组患者的头痛总发生率为 12.50 %，低于对照组的 32.50 %，差异具有统计学意义 （P ＜ 0.05）。两组患者阻滞成功率均为 100.00 %，且未见并发症发生。结论：甲状腺手术患者术前在超声引导下实 施右侧 SGB 干预的临床安全性高，能有效减少术后 24 h 的头痛、恶心呕吐发生率。

Abstract:

〔Abstract〕 Objective To investigate the effect of ultrasound-guided stellate ganglion block (SGB) intervention on surgical outcomes, headache, nausea and vomiting in patients undergoing thyroid surgery. Methods 80 patients undergoing thyroid surgery in Nanping First Hospital from March 2021 to March 2022 were selected and divided into a control group and an observation group, with 40 cases in each group, according to random number table method. Both groups were received general anesthesia with endotracheal intubation. The control group received SGB intervention by blind detection before surgery, while the observation group was received SGB intervention under ultrasound guidance before surgery. The anaesthesia related indicators of the two groups were observed and compared. Results The effective time of anesthesia in the observation group was shorter than that in the control group, and the difference was statistically significant (P < 0.05). There was no significant difference in anesthesia maintenance time between the two groups (P > 0.05). The postoperative 24 h value-at-risk syetem (VAR) score of nausea and vomiting of the observation group was (0.12 ± 0.03) points, lower than (0.35 ± 0.08) points of the control group, and the difference was statistically significant (P < 0.05). Within 24 h, the incidence of vomiting in the observation group was 5.00 %, lower than 22.50 % in the control group, and the difference was statistically significant (P < 0.05). There was no significant difference in the incidence of headache at 6 h, 12 h, 24 h and 48 h between the two groups (P > 0.05). The total incidence of headache in the observation group was 12.50 %, lower than 32.50 % in the control group, and the difference was statistically significant (P < 0.05). The success rate of block in both groups was 100.00 %, and no complications were observed. Conclusion Preoperative application of ultrasound-guided SGB can effectively reduce the incidence of postoperative nausea and vomiting and reduce headache attacks.