摘要
目的对比硬膜外复合全麻与腰硬联合麻醉对妇科腹腔镜手术患者血流动力学及血气的影响。方法选取妇科腹腔镜手术患者60例,依据麻醉方式不同分为观察组与对照组,各30例,观察组采用硬膜外复合全麻,对照组采用腰硬联合麻醉,观察2组不同时段血流动力学改变及血气变化。结果观察组气腹时血压(BP)、心率(HR)、心电图(ECG)与气腹前无统计学意义(P>0.05);对照组麻醉后SBP、DBP显著降低,10 min后HR、SBP、DBP与观察组比较有统计学意义(P<0.05);对照组气腹20 min时PaCO2、HCO-3较麻醉前显著升高(P<0.05),且显著高于观察组(P<0.05)。结论硬膜外复合全麻应用于妇科腹腔镜手术,能较好控制患者呼吸循环功能、维持血气状态,减轻机体应激反应,较腰硬联合麻醉更具优越性。
Objective To contrast the effect of compound epidural anesthesia with spinal-epidural anesthesia on the hemody- namics and blood gas of patients with gynecological laparoscopic surgery. Methods A total of 60 patients treated with gyne- cologic laparoscopic surgery were divided into observation group and control group on the basis of different anesthesia meth- ods （30 cases in each group）. The observation group was given the compound epidural anesthesia. And the control group was given spinal-epidural anesthesia. The changes of hemodynamics and blood gas at different time points were observed in two groups. Results The blood pressure, heart rate, and electrocardiogram in pneumoperitoneum of observation group had no ob- vious change compared with pre-pneumoperitoneum （ P 〉 0.05） ; SBP and DBP in control group was significantly reduced after anesthesia. HR, SBP and DBP were observed with a statistically significant difference after 10 min, compared with ob- servation group （ P 〈 0.05） ; PaCO2 and HCO3, of control group were significantly increased and higher than those of obser- vation group with 20 min pneunloperitoneum before anesthesia （ P 〈 O. 05）. Conclusion The compound epidural anesthesia applied in gynecological laparoscopic surgery can better maintain the natural state of patients with respiratory function, re- duce the body＇s stress response and has more advantages than spinal-epidural anesthesia.
出处
《长春中医药大学学报》
2014年第2期338-340,共3页
Journal of Changchun University of Chinese Medicine
基金
河北省张家口市科技计划项目(110115D)
关键词
硬膜外复合全麻
腰硬联合麻醉
妇科
腹腔镜手术
血流动力学
epidural anesthesia
spinal-epidural anesthesia
gynaecology
gynecologic laparoscopic surgery
hemodynamics
