RESUMO
Objective To investigate the analgesic efficacy and safety of decozine combined with sufentanil on patients after laparoscopic radical gastrectomy.Methods Sixty patients undergoing laparoscopic radical gastrectomy,American Society of Anesthesiologists (ASA) Ⅰ ～ Ⅱ,were selected,and were randomly divided into two groups.All of the patients were treated with intravenous-inhalation combined anesthesia,and was given patient controlled intraveous analgesia (PCIA) when the patient was awoken.PCIA was administered with subsequent bolus of 0.5 ml with lockout time 15 minutes and background infusion of 2 ml/h.A ratio (3 μg/kg) of sufentanil and 0.5 mg palonosetron were mixed in PCIA pump in sufentanil group (S group);and 1.5 μg/kg sufentanil,0.3 mg/kg dezocine,and 0.5 mg palonosetron in PCIA were mixed in dezocine combined with sufentainl group (DS group),they were diluted to 100 ml with saline.The visual analogue scale (VAS),Bruggrmann comfort scale (BCS),Ramsay and incidence of adverse reactions of two groups were observed in 2 h (T1),6 h (T2),12 h (T3),24 h (T4),48 h(T5) after operation.Results There was no significant difference of VAS and BCS between two groups at each time point after operation (P ＞ 0.05);The Ramsay score of S group was significantly higher than that of DS group at T1,T2,and T3 (P ＜ 0.05).The Ramsay scores of two groups at T4,T5 were lower than those of T1,T2,and T3.The incidence of nausea,vomiting of DS group was significantly lower than that of S group (P ＜0.05).Conclusions Dezocine combined with sufentainl used in PCIA on postoperative gastric cancer patients can obtain satisfactory analgesic effects,but has fewer side effects than single sufentainl.
RESUMO
Objective The aim of this study was to investigate the value of ultrasound in diagnosis of benign and malignant thyroid nodules with rim calcification. Methods Sixty thyroid nodules with rim calcifications from Sun Yat-sen University Cancer center which were detected on ultrasound from January 2008 to December 2015 were included in this study, and all the thyroid nodules had pathological results. Ultrasonic features of thyroid nodules, including the size, border, internal echo, growth pattern, rear echo, interruption or inner sink of the rim calcification and hypoechoic soft tissue extrusion around rim calcification were analyzed. Results Thirty-seven nodules (61.7%) were confirmed to be benign, and twenty-three nodules (38.3%) were malignant. The ultrasonic features of interruption or inner sink of rim calcifications and hypoechoic soft tissue extrusion around rim calcification, were more often in malignant nodules than benign nodules. The sensitivity, specificity, the positive predictive values and the negative predictive values for interruption or inner sink of rim calcifications were 85.7%, 89.4%, 85.7% and 89.4%, respectively. The sensitivity, specificity, the positive predictive values and the negative predictive values for hypoechoic soft tissue extrusion around rim calcification were 81.3%, 94.4%, 92.9% and 85.0%, respectively. Internal hypoechogenicity was more frequently observed in the malignant nodules (82.6%) than in benign nodules (40.5%). The longitudinal growth pattern of thyroid was more frequently observed in malignant nodules (30.4%) than in benign nodules (2.7%). The differences of this two ultrasound features were statistically significant(χ2=9.958 and 9.440,both P<0.01).There were no significant differences in size,border and the rear echo between malignant and benign nodules (all P>0.05). Conclusion The interruption or inner sink of the rim calcification could be useful in differential diagnosis of thyroid nodules with rim calcification.
