不同麻醉方法对妇科腹腔镜手术患者股静脉血流动力学影响  

Effects of general anesthesia and combined general-epidural anesthesia on femoral venous hemodynamics in gynecological laparoscopic operation

作　　者：莫伟波[1] 黎必万[1] 陆彬堂[1] 韦有全[1] 林丹丹[2] 

机构地区：[1]钦州市第二人民医院麻醉科,广西壮族自治区535000 [2]钦州市第二人民医院超声科,广西壮族自治区535000

出　　处：《中华实用诊断与治疗杂志》2010年第11期1094-1096,共3页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的:观察气管插管全身麻醉与气管插管全身麻醉复合硬膜外麻醉对妇科腹腔镜手术患者股静脉血流的影响。方法:56例行妇科腹腔镜手术患者,随机分为气管插管全身麻醉组28例(GA组)和气管插管全身麻醉复合硬膜外麻醉组28例(CGEA组)。分别于麻醉后气腹前(T0)、气腹形成后(T1)、术毕排气后麻醉恢复前(T2)采用彩色多普勒超声检测股静脉血流动力学的改变,同时监测生命体征变化。结果:2组T1,T2时股静脉直径均较T0增加(P<0.05);T1时CGEA组股静脉直径小于GA组(P<0.05)。T1时2组股静脉平均血流速度、平均血流量均较T0时下降(P<0.05),GA组较CGEA组下降更明显(P<0.05)。结论:气管插管全身麻醉复合硬膜外麻醉下行妇科腹腔镜手术对股静脉血流动力学影响更小。Objective To explore the effect of general anesthesia and combined general-epidural anesthesia on femoral venous hemodynamics in gynecological laparoscopic operation.Methods Fifty-six patients undergoing gynecological laparoscopic operation were randomly divided into general anesthesia group（GA group,n=28） and combined general-epidural anesthesia group（CGEA group,n=28）.Femoral venous hemodynamic changes were detemined with ultrasonography and systolic blood pressure,diastolic blood pressure and heart rate were recorded after anesthesia,during pneumoperitoneum and at the end of pneumoperitoneum,respectively.Results The diameters of the femoral veins increased significantly during pneumoperitoneum（P0.05） and at the end of pneumoperitoneum（P0.05） compared with those after anesthesia in two groups.The diameters of the femoral veins were smaller during pneumoperitoneum in CGEA group than those in GA group（P0.05）.The mean blood flow velocity and volume were lower during pneumoperitoneum than those after anesthesia in two groups（P0.05）,which was more obvious in GA group than in CGEA group（P0.05）.Conclusion Combined general-epidural anesthesia has little effect on femoral venous hemodynamics in gynecological laparoscopic operation.

关 键 词：全身麻醉 硬膜外麻醉 腹腔镜 妇科 股静脉 

分 类 号：R614.2[医药卫生—麻醉学]