全麻复合硬膜外与单纯全麻用于巨大肝癌手术效果比较  

Clinical Study of General Anesthesia Combined with Epidural Block and Simple General Anesthesia on Bulky Hepatocellular Carcinoma Resection

作　　者：魏秀吾[1] 王永忠[2] 上官明化[1] 范双炽[1] 

机构地区：[1]福建省三明市第二医院麻醉科,366000 [2]福建省三明市第二医院肿瘤科,366000

出　　处：《实用全科医学》2007年第3期201-202,共2页Applied Journal Of General Practice

基　　金：福建省卫生厅青年科研基金资助(编号2002-1-30)

摘　　要：目的观察全麻复合硬膜外与单纯全麻用于巨大肝细胞癌手术的可行性比较。方法96例随机分为全麻复合硬膜外48例(A组)和单纯全麻48例(B组)。A组术中麻醉维持以异丙酚3～5mg/(kg.h)微量泵持续输注,间歇静注芬太尼、阿曲库铵;硬膜外腔注药为1%利多卡因、0.25%丁卡因。B组全麻诱导手术中麻醉维持用药同A组。结果术中、术毕两组血糖值均升高,但B组更为显著,与诱导前比较差异有统计学意义(P<0.01);B组血糖值呈持续上升至拔管,与A组比较差异有统计学意义(P<0.05)。清醒拔管时间A组(18.0±4.7)min,B组(37.0±6.6)min,差异有统计学意义(P<0.01)。结论全麻复合硬膜外用于巨大肝细胞癌切除术,麻醉平稳,肌松满意,清醒快,对肝功能无明显影响,是安全可行的。Objective To investigate the feasibility of general anesthesia combined with epidural and simple general anesthesia on bulky hepatocellular carcinoma resection. Methods 96 cases were divided into two groups randomly. 48 cases in group A received general anesthesia combined with epidural, and 48 cases group B received simple general anesthesia. In group A, propofol 3 -5 mg/（ kg · h） was given with micro pump persistently during operation and fentanyl, atracurium was given intermittently. 1% lidocaine, 0.25% tetracaine were given in epidural cavity. Anesthetic drugs used in group B was the same with those in group A. Results During and after operation, blood sugar raised in both groups, especially in Group B （P 〈 0.01 ）. Compared with group A, blood sugar kept on ascending in Group B till extubated （ P 〈 0.05 ）. The extubation time ： group A was （ 18 ± 4.7 ） min,group B was （37 ± 6.6 ） min（ P 〈 0.01 ）. Conclusions General anesthesia combined with epidural block used in bulky hepatocellar carcinoma excision is safe and feasible. Satisfactory muscle relaxation, quick awake, no special infection on liver function are it＇s advantages.

关 键 词：全麻复合硬膜外 血糖 清醒时间 肝肿瘤切除术 

分 类 号：R735.7[医药卫生—肿瘤] R614.2[医药卫生—临床医学]