两种不同体位对颈丛阻滞甲状腺手术患者血压、心率的影响

目的探讨两种不同体位摆放方式对甲状腺手术期间患者血压、心率的影响。方法 ASAⅠ或Ⅱ级,颈丛麻醉下接受甲状腺手术的患者84例,随机分为两组,每组42例：对照组采用传统垂头仰卧位,观察组采用摇手术床摆垂头仰卧位体位。记录摆放体位前平卧位（T1）,摆放体位后5min（T2）、10min（T3）、30min（T4）、60min（T5）、90min（T6）各时间点的收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）及心率（HR）及术中地尔硫卓用药总量。结果两组在T1～T3时SBP、DBP和HR对比差异无统计学意义（P〉0.05）,观察组在T4～T6时的SBP、DBP、HR明显低于对照组,差异有统计学意义（P〈0.05）;观察组患者术中所应用盐酸地尔硫卓总量与对照组比较明显减少,差异有统计学意义（P〈0.05）。结论摇手术床摆垂头仰卧位能减少术中降压药盐酸地尔硫卓用量,明显缓解因体位不适而引起的甲状腺手术血压增高、心率增快等心血管反应。

The effect of the body position to the blood pressure and heart rate in thyroid surgery under cervial plexus block

Objective To investigate the effect of the operation posture to the blood pressure and heart rate in thyroid surgery under cervial plexum block. Methods Eighty-four patients,ASA I or II, aged 32 to 51 and scheduled for thyroid surgery, were randomly divided into observation group and control group of 42 patients each. The thyroid operation posture were placed by setting the operation table in the observation group while the control group adopted routine thyroid operation posture. The SBP, DBP and HR of the patients before （T1） and after the posture been set 5 min （T2）, 10 min （T3）, 30 min （T4）, 60 min （T5） and 90 min （T6） were caculated, and the dosage of dihiazem hydrochloride were recorded. Results The SBP, DBP and HR between two groups at T1-T3 had no significant difference （P 〉 0.05）; The SBP, DBP and HR of the observation group was lower than that of the control group （P 〈 0.05） at T4-T6. The dosage of dihiazem in the observation group was significantly less than that of the control group （P 〈 0.05）. Conclusion Setting the operation table to place the trendelenburg position can reduce the SBP, DBP and HR of patients.