不同麻醉方法对妇科盆腔手术患者应激反应的影响  

Influence of Anesthetic Aproaches on Stress Response Occurring in Gynecological Operation

作　　者：周颖[1] 凤婧[2] 刘浩东[1] 李振英[3] 胡西会[1] 

机构地区：[1]宝鸡市妇幼保健院麻醉科,陕西宝鸡721000 [2]宝鸡市妇幼保健院妇科,陕西宝鸡721000 [3]宝鸡市妇幼保健院内科,陕西宝鸡721000

出　　处：《医学综述》2010年第23期3644-3646,3653,共4页Medical Recapitulate

基　　金：宝鸡市卫生局科研课题(200815)

摘　　要：目的观察不同麻醉方法对妇科盆腔手术患者应激反应的影响。方法选择行妇科盆腔手术患者45例随机分为腰硬联合麻醉组(A组)、全麻组(B组)、全麻复合硬膜外阻滞组(C组)各15例,于麻醉前、麻醉后5min、切开腹膜时、手术最强刺激时、术毕5个时间点,采集静脉血测定皮质醇(COR)、血糖和儿茶酚胺浓度,并记录MAP及心率。结果麻醉后B组患者MAP、心率明显升高(P<0.01),C组虽有升高趋势,但差异无统计学意义。随着手术的进行,3组患者COR、血糖及儿茶酚胺逐渐升高,以B组升高尤为明显(P<0.01)。结论全麻复合硬膜外阻滞有效地抑制了麻醉及手术引起的应激反应,是妇科手术理想的麻醉方法。Objective To study the effects of anesthetic approaches on stress response occurring in gynecological operation.Methods Forty-five patients scheduled for gynecological procedures were randomly divided into three groups：CSEA group（group A,n=15）,GA group（group B,n=15）,and GEA group（group C,n=15）.Blood samples were collected before anesthesia,5 min after anesthesia,on opening the peritoneum,at the strongest stimulation,and at the finish to determine the biochemcial measures,including corticosteroid（COR）,blood glucose（BG）,catecholamine（CA）.The changes in MAP and HR were also recorded.Results After anesthesia,the MAP and HR in group B significantly increased（P0.01）,group C showed a tendency in increasealthough not significantly.COR,BG and CA in the three groups gradually increased in the process of gynecological procedure,particularly in group B（P0.01）.Conclusion General anesthesia combined with epidural block could effectively suppress the anesthesia and surgery-induced stress response.

关 键 词：麻醉 手术 应激反应 

分 类 号：R614[医药卫生—麻醉学]