摘要
目的:观察全麻和全麻复合硬膜外麻对老年患者腹腔镜下胆囊切除术应激反应的影响。方法:腹腔镜胆囊切除术老年患者40例,随机分为全麻组(GA)和全麻复合硬膜外麻组(GEA),GA组麻醉诱导后行气管内插管,GEA组实施硬膜外穿刺置管后再完成全麻诱导、插管,分别于麻醉前、插管后、气腹后、术中30分钟、拔管后即刻测定患者外周血中的血糖(Glu)、皮质醇(Cor)、C反应蛋白(CRP),记录各时段BP、MAP、HR、PETCO2值。结果:GA组血糖(Glu)、皮质醇(Cor)、C反应蛋白(CRP)在术中30分钟、拔管后明显高于GEA组(P<0.05),两组Glu、CRP在术中30分及拔管后均高于麻醉前(P<0.05),GEA组MAP、HR在术中较GA组相对平稳,但两组间无统计学差异(P>0.05)。结论:全麻复合硬膜外麻对腹腔镜下胆囊切除术老年患者的应激反应较单纯全麻更小。
Objective ：To explore the effects of Stress Response of general anesthesia and general anesthesia combined with epidural anesthesia for aged patients, who underwent laparoscopic cholecystectomy （ LC ）. Methods：Forty aged patients who underwent LC were divided into general anesthesia group （GA, 20 cases ） and general anesthesia combined with epidural anesthesia group （GEA ,20cases）. The following data of two groups-were recorded： the concentration of blood suger（Glu）, cortisol （ Cot）, C - reactive protein （CRP） and the date of MAP. HR at the moment of entrance of oeration - room, after racheal intnbation, establishmerit of pneumoperitoneum, thirty minutes of operation done and after extubation. Results ：. the Glu,Cor, CRP of group GEA was more lower than group GA at the thirty minutes of operation done and after extubation , which was significantly different between two groups （ P 〈 0. 05 ）, The hemodynamics （HR,MAP） of group GEA was more stable than group GA, but which was not significantly different （ P 〉 0. 05 ）. Conclusions ： General anesthesia combined with epidural anesthesia for aged patients who underwent LC can decrease stress reaction during operation.
关键词
应激反应
老年
腹腔镜胆囊切除术
全麻
硬膜外麻
Stress Response, Aged, Cholecystectomy laparoscopic, General Anesthesia, epidural Anesthesia
