经皮肾镜双导管Cyberwand碎石术的麻醉方式选择  

The clinical analysis of anesthesia for percutaneous nephroscopic lithotripsy with novel dual probe Cyberwand

作　　者：皮名芳[1,2] 陈春[1,2] 胡敬祖[1,3] 林雷[1,2] 

机构地区：[1]三峡大学第一临床医学院 [2]宜昌市中心人民医院麻醉科,湖北宜昌443003 [3]宜昌市中心人民医院泌尿外科,湖北宜昌443003

出　　处：《西部医学》2015年第2期232-234,共3页Medical Journal of West China

摘　　要：目的探讨经皮肾镜双导管Cyberwand碎石术更合适的麻醉方法及其安全性。方法回顾性分析2012年11月至2013年10月择期行经皮肾镜双导管Cyberwand碎石术68例肾结石患者的麻醉临床资料,随机分为硬膜外组和气管插管全麻组,各34例。观察两组麻醉前、麻醉后15分钟、俯卧位后、灌注碎石30min、灌注碎石60min、术毕几个时点的平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(SpO2)、中心静脉压(CVP)的变化及不良反应与处理。结果全麻组MAP、HR显得相对稳定,而硬膜外组俯卧位后MAP明显下降(P<0.05),灌注碎石30min、60min时HR明显增快,与麻醉前和全麻组比较有统计学意义(P<0.05),两组术毕时CVP较麻醉前明显上升(P<0.05);不良反应硬膜外组高于全麻组(P<0.05)。结论经皮肾镜Cyberwand碎石术患者选择气管插管全麻比硬膜外麻更为稳定、安全、舒适,是一种理想的麻醉方式。Objective To evaluate appropriate anesthesia methods and safety for percutaneous nephrolithotomy lithotripsy with novel dual probe Cyberwand.Methods Retrospective analysis of the clinical anesthesia data of patients suffered percutaneous nephroscopic lithotripsy with novel dual probe Cyberwand patients.The patients were divided into epidural anesthesia group and general anesthesia group randomly,34 cases in each.MAP,HR,SpO2,CVP at the time of preanesthesia,after anesthesia 15 minutes,the prone position,perfusion 30 min,perfusion 60 min and finish were recorded,and operation time,intraoperative lavage total,adverse reactions were compared respectively.Results The MAP and HR of General anesthesia group was relatively stable,while the MAP of epidural group decreased significantly at the time of prone position,the HR increased obviously at the time of 30 min,60min after perfusion,compared with preanesthesia and general anesthesia group（P〈0.05）,the CVP of two group after operation was significantly increased than preanesthesia（P〈0.05）;adverse reactions of epidural group was higher than that of general anesthesia group（P〈0.05）.Conclusion Tracheal intubation anesthesia for percutaneous nephrolithotomy lithotripsy with novel dual probe Cyberwand is more stable,safe and comfort than epidural anesthesia.

关 键 词：经皮肾镜碎石术 双导管Cyberwand 麻醉 

分 类 号：R614.2[医药卫生—麻醉学]