不同麻醉方式在腹腔镜子宫切除术中的麻醉效果分析  

The effect of different anesthetic methods in patients with laparoscopic hysterectomy

作　　者：梅静[1] 陈晓芳[1] 徐桂萍[1] 

机构地区：[1]新疆维吾尔自治区人民医院麻醉科,乌鲁木齐830001

出　　处：《中国医学前沿杂志（电子版）》2015年第6期73-75,共3页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：国家自然科学基金资助项目(81160016)

摘　　要：目的探讨不同麻醉方式在腹腔镜子宫切除术中的麻醉效果。方法选取2011年1月至2014年6月于本院行择期腹腔镜子宫切除术的168例患者为研究对象,随机分为观察组与对照组,每组各84例。观察组患者采用硬膜外麻醉复合全身麻醉,对照组患者采用全身麻醉,对比分析两组患者术中及术后相关指标变化情况。结果观察组患者自主呼吸恢复时间、术后拔管时间及术后清醒时间均短于对照组,术后躁动发生率及术后追加阵痛药物的患者比例均低于对照组(P<0.05)。观察组患者麻醉后平均动脉压(MAP)低于对照组,血氧饱和度(Sp O2)高于对照组(P<0.05)。观察组患者T2、T3时间点血糖水平,T1、T2、T3时间点皮质醇、肾上腺素及去甲肾上腺素水平均低于对照组(P<0.05)。结论硬膜外麻醉复合全身麻醉可通过阻断交感神经传导,降低气腹对腹腔镜子宫切除术患者的应激反应,稳定患者的呼吸、循环功能,并能保持患者血糖、皮质醇、肾上腺素及去甲肾上腺素水平稳定,值得临床推广应用。ObjectiveTo study the effect with different anesthetic methods in patients with laparoscopic hysteretomy.Method168 cases of patients laparoscopic hysterectomy from January 2011 to June 2014 in our hospital were randomly divided into observation group and control group. Patients in observation group were treated with epidural anesthesia combined with general anesthesia, patients in control group were treated with simple general anesthesia.ResultBreathing recovery time, postoperative extubation time and postoperative waking hours of patients in observation group were shorter than control group. Incidence of postoperative agitation and the proportion of patients with postoperative additional pain drugs were lower than control group （P〈0.05）. Mean artery pressure （MAP） was lower than control group, and SpO2 was higher than control group. Level of blood glucose at T2, T3 time, leve of cortisol, epinephrine and norepinephrine at T1, T2 and T3 time were lower than control group （P〈0.05）.ConclusionEpidural anesthesia combined with general anesthesia can block the sympathetic nerve conduction, reduce stress response of patients with laparoscopic hysterectomy, remained respiratory and circulatory function stable, keep stable level of blood glucose, cortisol and epinephrine and norepinephrine, and it is worthy of clinical popularization and application.

关 键 词：腹腔镜子宫切除术 硬膜外麻醉 全身麻醉 

分 类 号：R614[医药卫生—麻醉学]