摘要
目的探讨全麻复合硬膜外麻醉对直肠癌老年患者腹腔镜手术治疗的临床效果。方法便利选取2014年10月—2016年10月于该院行腹腔镜直肠癌根治术的老年患者58例,随机分为观察组和对照组各29例,观察组采用全麻复合硬膜外麻醉,对照组采用单纯全麻方式,对比两组患者手术过程中各个时间点的HR及MAP变化情况及苏醒质量。结果术前、切皮、气腹20 min、术毕观察组的HR分别为(65.22±8.13)、(70.17±9.86)、(71.26±8.86)、(69.36±9.98),对照组分别为(71.49±11.27)、(87.52±11.78)、(89.13±11.25)、(80.17±7.58);术前、切皮、气腹20 min、术毕观察组的MAP分别为(9.93±1.14)、(10.64±2.21)、(9.45±1.17)、(10.17±1.16),对照组分别为(10.19±1.28)、(13.98±1.44)、(14.24±1.36)、(13.28±1.37),两组患者手术过程中各时间段HR、MAP观察组均较对照组低(P<0.05),且变化平稳。观察组自主呼吸恢复时间、拔管时间、完全清醒分别为(6.81±1.88)、(16.48±1.37)、(45.42±3.69)min;对照组分别为(12.94±1.76)、(10.16±2.39)、(26.41±2.47)min;观察组自主呼吸恢复时间、拔管时间、完全清醒时间均短于对照组(P<0.05)。结论全麻复合硬膜外麻醉方式能够满足手术操作需要,控制手术过程中应激引起的生理改变,有利于患者术后早期苏醒与拔管,减轻术中和术后各类并发症。
Objective To discuss the clinical effect of General anesthesia combined with epidural anesthesia in the laparoscopic surgery treatment of senile patients with rectal carcinoma. Methods 58 cases of senile patients with laparoscopic radical resection of rectal cancer in our hospital from October 2014 to October 2016 were convenient selected and randomly divided into two groups with 29 cases in each, the observation group adopted the general anesthesia combined with epidural anesthesia, while the control group adopted the simple general anesthesia, and the HR and MAP changes and awakening quality in various time points in the operation course were compared between the two groups. Results The HR in the observation group before operation, at skin incision, in 20 min after pneumoperitoneum and at the end of operation was respectively（65.22±8.13）,（70.17±9.86）,（71.26±8.86）,（69.36±9.98） and（71.49±11.27）,（87.52±11.78）,（89.13±11.25）,（80.17±7.58） in the control group, and the MAP in the observation group and in the control group before operation, at skin incision, in 20 min after pneumoperitoneum and at the end of operation were respectively（9.93±1.14）,（10.64±2.21）,（9.45±1.17）,（10.17±1.16） and（10.19±1.28）,（13.98±1.44）,（14.24±1.36）,（13.28±1.37）, and the HR and MAP in various time phases in the operation course in the observation group were lower than those in the control group（P〈0.05）, and the changes was steady,and the spontaneous respiration recovery time, tube drawing time and fully awakening time in the observation group and in the control group were respectively（6.81±1.88）,（16.48±1.37）,（45.42±3.69）min and（12.94±1.76）,（10.16±2.39）,（26.41±2.47）min, and the difference was statistically significant（P〈0.05）. Conclusion The general anesthesia combined with epidural anesthesia can meet the operation demands and control the physical changes caused by the stress in the operation course, and it is conducive to the postoperative early awakening and tube drawing of patients and relieving various complications in operation and after operation.
出处
《中外医疗》
2017年第17期109-110,116,共3页
China & Foreign Medical Treatment
关键词
硬膜外麻醉
全麻
腹腔镜
腹腔镜直肠癌根治术
Epidural anesthesia
General anesthesia
Laparoscopic
Laparoscopic rectal radical excision
