两种麻醉方式对腹腔镜胆囊切除术患者股静脉血流动力学的影响  

Effects of general anesthesia and combined general epidural anesthesia on femoral venous hemodynamica in patients undergoing laparoscopic cholecystectomy

作　　者：莫伟波[1] 黎必万[1] 檀文好[1] 陆彬堂[1] 林丹丹[2] 

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

出　　处：《西部医学》2010年第12期2262-2264,共3页Medical Journal of West China

摘　　要：目的观察插管全麻和插管全麻复合硬膜外麻醉对行腹腔镜胆囊切除术患者股静脉血流的影响。方法将行腹腔镜胆囊切除术患者64例,随机分为插管全麻组(GA组)和插管全麻复合硬膜外麻醉组(CGEA组),每组各32例。GA组行麻醉诱导后气管插管,接麻醉机行机械通气。CGEA组于麻醉诱导前先行硬膜外麻醉。两组术中静脉维持麻醉,同时辅助吸入异氟醚维持麻醉,CGEA组硬膜外腔间断给予0.75%布比卡因维持硬膜外麻醉。分别与麻醉后气腹前(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。结果 T1时两组股静脉直径均增加(P<0.05),T2时仍未能完全恢复正常(均P<0.05),T1时CGEA组股静脉直径小于GA组(P<0.05);T1时两组股静脉平均血流速度、平均血流量均下降(均P<0.05),GA组下降更明显(P<0.05)。结论全麻复合硬膜外麻醉下行腹腔镜胆囊切除术对手术及气腹引起的股静脉血流动力学影响更小。Objective To examine the effect of general anesthesia and combined general epidural anesthesia on femoral venous hemodynamica in patients undergoing laparoscopic cholecystectomy.Methods 64 patients undergoing laparoscopic cholecystectomy were randomly divided into general anesthesia group（GA group,N=32） and combined general-epidural-anesthesia group（CGEA group,N=32）.Femoral venous hemodynamica was measured by ultrasonography after anesthesia,during pneumoperitoneum and at the end of pneumoperitoneum.Results Compared with after anesthesia,the diameter of the femoral veins increased significantly during pneumoperitoneum（P0.05）.The velocity and the blood flow decreased markedly（P0.05） during pneumoperitoneum in each group.The diameter of the femoral veins was lower and the blood flow rate was higher in CGEA group during pneumoperitoneum than those in GA group（P0.05）.Conclusion Combined general epidural anesthesia had little effect on femoral venous hemodynamica in patients undergoing laparoscopic cholecystectomy.

关 键 词：全身麻醉 硬膜外麻醉 腹腔镜 胆囊切除术 股静脉 

分 类 号：R614.2[医药卫生—麻醉学]