212例腹腔镜胆囊切除术麻醉体会  

Experience of anesthesia in 212 patients with laparoscopic cholecystectomy

作　　者：陈兴东[1] 林宁[1] 胡益民[1] 段满林[1] 李伟彦[1] 

机构地区：[1]南京军区南京总医院麻醉科,江苏南京210002

出　　处：《医学研究生学报》2007年第8期836-837,共2页Journal of Medical Postgraduates

基　　金：南京军区南京总医院重点课题基金资助项目(批准号:2003076)

摘　　要：目的:探讨腹腔镜胆囊切除术的麻醉问题。方法:回顾212例行腹腔镜胆囊切除术患者的临床资料,总结分析在气管插管静吸复合麻醉下手术患者的呼吸、循环、血流动力学和应激反应情况。结果:212例均取得了良好的麻醉效果,术中生命体征平稳,术后苏醒快。在快速诱导麻醉即刻,可观察到部分患者血压轻度下降、心率减慢现象。在造气腹后,部分患者的心率、收缩压均有所升高,并持续于气腹的全过程,手术后恢复至气腹前水平。所有患者术后均无缺氧、呼吸抑制、呼吸道梗阻及低血压等严重并发症。结论:气管插管静吸复合麻醉下行腹腔镜胆囊切除术对患者的影响比较小,术后恢复快,无并发症,是安全有效的麻醉方法。Objective：To discuss the anesthesia methods of laparoscopic cholecystectomy （LC）. Methods：Two hundred and twelve patients receiving LC were retrospectively reviewed. All patients receiving laparoscopic cholecystectomy had combined intravenous and inhaled anesthesia（CIIA） under endotracheal intubation. The indexes of patients＇respiratory, circulatory and stress reactions were analyzed. Results：Vital signs of the patients were stable during the operation and consciousness recovered soon after the operation. HR and BP decreased at the point of rapid sequence intubation in some patients. In some patients, HR and BP increased a little bit and were kept at high level during the whole course of pneumoperitoneum after pneumoperitoneum formation, which fell back to the baseline valve after the operation. Severe complications such as respiratory suppression, airway obstruction and hypotension were not found in all patients. Conclusion： Combined intravenous and inhaled anesthesia（CIIA） under endotracheal intubation is a safe and effective anesthesia method to patients undergoing laparoscopic cholecystectomy.

关 键 词：胆囊切除术 腹腔镜 麻醉 

分 类 号：R575.6[医药卫生—消化系统]