不同麻醉下腹腔镜胆囊切除术后的观察  

The observation and nursing of laparoscopic cholecystectomy by different anesthetize method

作　　者：柯巧芸[1] 黄饶英[1] 苏迎春[1] 

机构地区：[1]福建省厦门市第二医院,福建厦门361002

出　　处：《护士进修杂志》2001年第4期259-260,共2页Journal of Nurses Training

摘　　要：目的比较两种麻醉方法行腹腔镜胆囊切除后护理的差异。方法将 80例ASAⅠ～Ⅱ级经腹腔镜胆囊切除手术病人随机分为两组 :全麻组按常规方法诱导后气管插管静脉复合麻醉 ;硬膜外组选T9～10 间隙穿刺 ,2 %利多卡因硬膜外阻滞。分别于入室前、术后返回病房两个时点记录血流动力学参数及术后不良反应项目。结果全麻组术后血压、心率较入室前明显提高 ,P <0 0 1;硬膜外组血压、心率无明显差异 ,P >0 0 5。术后呼吸道梗阻 ,呕吐、肩部酸痛等不良反应发生率全麻组明显高于硬膜外组。结论对于腹腔镜胆囊切除术应用硬膜外麻醉 ,术后病人清醒 ,血流动力学相对稳定 ,并发症少 ,护理较为简便。全麻术毕气管拔管的应激反应仍持续于术后相当一段时间 ,血流动力学波动明显 ,不良反应发生率较高。因此应加强术后护理工作 ,以确保病人安全。Objectives To compare the difference of nursing after laparosopic cholecystectomy by two anesthetize methods.Method 80 cases patients for laparosopic cholecystectomy of ASAⅠ Ⅱ grade were divided into two groups;general anesthesia group,by routine induce tracheal tuber insertion and anesthetize by vein;epiduaral anesthesia group,epidural T 9 T 0 puncture and injecting with 2% dolicanine.The blood dynamic indicator and side effect after operation were analyzed in the ward before and after operation.Results in general group,the blood pressure and heart rate after operation was higher than that of before operation ( P <0 01).there is no significant difference on BP and HR before and after operation in epidural anesthesia group ( P >0 05),thg incidence of respiratory truck obstruction,vomiting and shoulder ache in general anesthesia group were higher than that in epidural anesthesia group.Conclusion By epidual anesthesia,the patients after laparosopic cholecystectomy were wake,stable in blood dynamic,less complication and easy to nurse.But the patients after operation By general anesthesia,the stress reaction last long after operation,unstable in blood dynamic and higher incidence of side effect.So intensive nursing are nacessary to ensure the safety of the patients.

关 键 词：麻醉 腹腔镜胆囊切除 术后护理 气管插管静脉复合麻醉 硬膜外麻醉 

分 类 号：R657.41[医药卫生—外科学] R614[医药卫生—临床医学]