两种麻醉方式对老年腹腔镜下胆囊切除术患者围术期应激反应的影响分析  

Effects of two anesthesia for cholecystectomy perioperative laparoscopic surgery in elderly patients under stress analysis

作　　者：吴旭[1] 王雷 李福仙[1] 周蕾[1] 

机构地区：[1]大连大学附属中山医院麻醉科,辽宁大连116001 [2]武警大连医院外科,辽宁大连116013

出　　处：《中国医刊》2016年第11期66-68,共3页Chinese Journal of Medicine

摘　　要：目的分析研究两种麻醉方式对老年腹腔镜下胆囊切除术患者围术期应激反应的影响。方法选取2014年1月至2016年1月在大连大学附属中山医院进行腹腔镜下胆囊切除术(laparoscopic cholecystectomy,LC)的老年患者72例,随机分为试验组、对照组,对照组实施全身麻醉,试验组实施硬膜外麻醉复合全身麻醉,对两组患者的各个时间段的血糖(glucose,Glu)、皮质醇(cortisol,Cor)、C反应蛋白(C-reactive protein,CRP)及血流动力学指标进行对比。结果试验组患者手术开始后30分钟以及拔管以后的Glu、Cor以及CRP水平明显低于对照组(P<0.05);两组患者的各个时间段血流动力学指标之间的差异无显著性(P>0.05)。结论对老年腹腔镜下胆囊切除术患者采取硬膜外麻醉复合全身麻醉,可以使围术期的应激反应明显降低,使手术得以顺利进行,具有临床推广价值。Objective To analyze the study of two patients under anesthesia resection perioperative stress response in elderly under laparoscopic cholecystectomy.Method 72 cases of LC（laparoscopic cholecystectomy） in elderly patients select in our hospital from January 2014 to 2016 January,were randomly divided into experimental group and control group,control group received general anesthesia,general anesthesia in the experimental group received epidural anesthesia,for each period of time of the two groups were Glu,Cor,CRP and hemodynamics were compared.Result Among patients undergoing experimental group and 30 minutes after extubation Glu（glucose）,Cor（cortisol） and CRP（C-reactive protein） levels were significantly lower than the control group（P〈0.05）;each time two groups of patients mechanical index difference between the blood flow was not statistically significant（P〉0.05）.Conclusion The laparoscopic cholecystectomy in aged patients taking epidural anesthesia combined with general anesthesia can make the perioperative stress response was significantly reduced,so that the operation can proceed smoothly,with a clinical value.

关 键 词：麻醉方式 老年腹腔镜下胆囊切除术 围术期 应激反应 

分 类 号：R614[医药卫生—麻醉学]