基础医学与临床 ›› 2020, Vol. 40 ›› Issue (10): 1399-1402.

• 临床研究 • 上一篇    下一篇

3种分泌型垂体瘤切除术术后躁动及恢复质量的比较

张羽冠1, 唐帅1*, 薛杨1, 张越伦2, 田园1, 幸兵3, 黄宇光1   

  1. 1.中国医学科学院 北京协和医学院 北京协和医院 麻醉科;
    2.中国医学科学院 北京协和医学院 北京协和医院 医学科学研究中心;
    3.中国医学科学院 北京协和医学院 北京协和医院 神经外科, 北京 100730
  • 收稿日期:2020-03-12 修回日期:2020-07-27 出版日期:2020-10-05 发布日期:2020-09-29
  • 通讯作者: * tangshuai@pumch.cn

Comparison of emergence agitation and recovery quality after hypophysectomy of 3 endocrine types of pituitary tumors

ZHANG Yu-guan1, TANG Shuai1*, XUE Yang1, ZHANG Yue-lun2, TIAN Yuan1, XING Bing3, HUANG Yu-guang1   

  1. 1. Department of Anesthesiology;
    2. Medical Research Center;
    3. Department of Neurosurgery, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730, China
  • Received:2020-03-12 Revised:2020-07-27 Online:2020-10-05 Published:2020-09-29
  • Contact: * tangshuai@pumch.cn

摘要: 目的 评估3种垂体瘤患者经鼻蝶切除术后苏醒期躁动及恢复质量。方法 选择2016年3月至11月全麻下行择期切除垂体瘤患者,分为3组:生长激素组(GH)、促肾上腺皮质激素组(ACTH)和无功能组(control)。在恢复室应用Riker镇静躁动评分(RSAS)记录苏醒期患者的躁动情况,患者带管呛咳的严重程度,头痛评分(VAS评分)。术后24 h随访记录40项恢复质量评分量表(QoR-40),患者头痛(VAS评分),恶心呕吐(VRS评分),是否有咽喉疼痛及患者麻醉满意度。结果 GH组共纳入51例,ACTH组44例,control组68例。苏醒期及术后24 h各组患者躁动无显著差异。术后24 h VRS评分提示CT组高于control组(P<0.01),VAS评分提示ACTH组高于control组(P<0.001)。术后咽喉疼痛中ACTH组发生率高于control组(P<0.05)。术后24 h QoR-40评分,ACTH组显著低于control组(P<0.01)。结论 分泌促肾上腺皮质激素的患者术后恶心、头痛、咽喉痛的发生率显著升高、QoR-40的评分显著减低。

关键词: 垂体瘤切除术, 苏醒期躁动, 40项恢复质量评分量表

Abstract: Objective To evaluate the emergence agitation and recovery quality of patients with 3 endocrine types of pituitary tumor after transnasal transsphenoidal hypophysectomy. Methods Patients who received pituitary adenoma resection under general anesthesia were enrolled and categorized into three groups: growth hormone group (GH), adrenocorticotropic hormone group (ACTH) and non-functional group (control). Riker Sedation-Agitation Scale (RSAS), the severity of the emergence coughing, headache (by VAS), medical staff satisfaction were recorded in the post-anesthesia care unit. QoR-40 score, headache(by VAS), nausea score (by VRS) and vomiting score, and patient satisfaction were recorded at 24 h postoperatively. Results 163 cases were enrolled in the analysis, including 51 in GH group, 44 in ACTH group and 68 in control group. No significant difference was found regarding the emergence agitation among 3 groups. The ACTH group showed significantly higher nausea VRS score at 24 h after surgery than control group (P<0.01). The headache VAS score of ACTH group was significantly higher than that in control group (P<0.001). The incidence of postoperative sore throat in ACTH group was significantly higher than that in control group (P<0.05). The postoperative QoR-40 score of ACTH group was significantly lower than that of control group (P<0.01). Conclusions The incidences of postoperative nausea, headache and sore throat are significantly increased and the score of QoR-40 is significantly reduced in patients with ACTH pituitary adenoma.

Key words: hypophysectomy, emergence agitation, Quality of Recovery-40

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