【摘要】 目的：评价气管内滴入与静脉泵入右美托咪定对甲状腺手术患者术后呛咳反应的影响。方法：选择2023年6月—2024年4月九江市第一人民医院收治的80例择期行甲状腺切除术患者，采用随机数字表法分为DT组（右美托咪定于麻醉诱导后10 min经气管内缓慢滴入，n=27）、DV组（右美托咪定于麻醉诱导后10 min静脉泵入，10 min内输注完成，n=27）、C组（不使用右美托咪定，于麻醉诱导后10 min静脉泵入生理盐水，n=26）。测量并记录三组诱导前（T₀）、插管后（T₁）、用药即刻（T₂）、用药后10 min（T₃）、用药后20 min（T₄）、拔管时（T₅）及拔管后3 min（T₆）的SBP、HR；记录三组手术指标、苏醒期安全指标、不良反应发生率。结果：T₄、T₅、T₆时，DT组和DV组的SBP低于C组（P<0.05）；T₄、T₅、T₆时，DT组的HR低于C组，T₃、T₄、T₅、T₆时，DV组的HR低于C组（P<0.05）。三组麻醉时长、手术时长、苏醒时间比较，差异无统计学意义（P>0.05）。DT组和DV组的呛咳反应评分优于C组，拔管后10 min Riker镇静-躁动评分、术后2 h VAS评分明显低于C组（P<0.05）。DV组心动过缓发生率高于DT组、C组，且三组心动过缓发生率比较，差异有统计学意义（P<0.05）。结论：通过气管内滴入和静脉泵入右美托咪定都具有降低术后呛咳反应发生率、稳定血流动力学、减少术后疼痛等作用，气管内滴入较静脉泵入右美托咪定心动过缓发生率更低。更多还原

【Abstract】 Objective:To evaluate the effects of intratracheal instillation and intravenous pumping of Dexmedetomidine on postoperative choking cough reactions in patients undergoing thyroid surgery.Method:A total of 80 patients scheduled for thyroid surgery admitted to Jiujiang NO.1 People’s Hospital from June 2023 to April 2024 were selected and divided into the DT group （Dexmedetomidine was slowly instilled through the trachea 10 minutes after anesthesia induction,n=27） and the DV group （Dexmedetomidine was intravenously pumped10 minutes after anesthesia induction,infusion was completed within 10 minutes,n=27）,group C （Dexmedetomidine was not used,normal saline was intravenously pumped 10 minutes after anesthesia induction,n=26） by random number table method.The SBP and HR of the three groups before induction （T₀）,after intubation （T₁）,immediately after medication （T₂）,10 minutes after medication （T₃）,20 minutes after medication （T₄）,at extubation （T₅）,and 3 minutes after extubation （T₆） were measured and recorded.The surgical indicators,safety indicators during the recovery period,and the incidence of adverse reactions in the three groups were recorded.Result:At T₄,T₅ and T₆,the SBP of the DT group and the DV group were lower than those of the group C （P<0.05）.At T₄,T₅ and T₆,the HR of the DT group were lower than those of the group C;at T₃,T₄,T₅ and T₆,the HR of the DV group were lower than those of the group C （P<0.05）.There were no statistically significant differences in the comparison of anesthesia duration,operation duration and recovery time among the three groups （P>0.05）.The choking cough response scores of the DT group and the DV group were better than those of the C group,the Riker sedation-agitation score 10 minutes after extubation and the VAS score 2 hours after surgery were significantly lower than those of the group C （P<0.05）.The incidence of bradycardia in the DV group was higher than those of DT group and group C,and the comparison of the incidence of bradycardia among the three groups showed statistically significant differences （P<0.05）.Conclusion:Both intratracheal instillation and intravenous pumping of Dexmedetomidine have the effects of reducing the incidence of postoperative choking cough reactions,stabilizing hemodynamics,and reducing postoperative pain.The incidence of bradycardia by intratracheal instillation is lower than that by intravenous pumping of Dexmedetomidine.更多还原