全身麻醉复合硬膜外麻醉对腹腔镜直肠癌根治术患者心输出量影响  

作　　者：王斌[1] 李军[1] 后瑞淼 曹福羊[1] 李娟[1] 

机构地区：[1]中国人民解放军海军总医院,100046

出　　处：《浙江临床医学》2016年第7期1224-1226,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨全身麻醉复合硬膜外麻醉对腹腔镜直肠癌根治术患者心输出量的影响。方法直肠癌行腹腔镜手术患者56例，随机分为单纯气管插管全身麻醉组与气管插管全身麻醉复合硬膜外麻醉组，每组各28例，对两组患者血流动力学指标、心排血量（CO）、外周血管阻力（SVR）、心肌加速度指数（ACI）、胸液成分（TFC）变化情况进行分析，并比较两组患者的苏醒质量。结果观察组患者术中30min的CO高于对照组，差异有统计学意义，观察组患者手术开始时、术中30min的SVR、ACI、TFC与对照组比较，差异有统计学意义（P〈0．05），观察组患者的睁眼时间、拔管时间和正确回答问题时间均短于对照组，差异有统计学意义（P〈0．05）。结论全身麻醉复合硬膜外麻醉对腹腔镜直肠癌手术患者心输出量的影响较单纯全身麻醉影响小，推荐麻醉科医师应用。Objective To observe the effect of general combined with epidural anesthesia on cardiac output in the elderly undergoing laparoscopic radical rectal cancer operation. Methods 56 patients with rectal cancer and willing to receive laparoscopic surgery was collected from our department, then divided into two groups by using the random number table method, the general anesthesia group and endotracheal intubation anesthesia combined with epidural anesthesia group respectively, 28 cases in each group, to analyze the hemodynamics index, cardiac output （ CO ） , peripheral vascular resistance （ SVR ） , myocardial acceleration index （ ACI ） , thoracic fluid content （ TFC ） , and to compare the recovery quality between the two groups. Results The cardiac output at 30rain in the observation group patients was higher than the control group, the difference was statistically significant, the difference of the peripheral blood vessel resistance, myocardial acceleration index, and myocardial acceleration index at the beginning of operation and intraoperative 30min were statistically significant between the observation group and the control group （ P〈0.05 ） , the eye opening time and ptdl tube time and correct answer question time in the observation group was less than the control group, the difference had statistical significance （ P〈0.05 ） . Conclusion The effect of general combined with epidural anesthesia on cardiac output in the elderly undergoing laparoscopic radical rectal cancer operation is significant and is worth of recommendation.

关 键 词：全身麻醉 硬膜外麻醉 腹腔镜 直肠癌 心输出量 

分 类 号：R735.37[医药卫生—肿瘤]