腰硬联合麻醉用于截瘫患者自主神经高反应手术的麻醉效果及安全性  

Anesthetic Effect and Safety of General Anesthesia and Combined Spinal and Epidural Anesthesia used in Autonomic Nervous Hyperresponsive Surgery for Patients with Paraplegia

作　　者：杜如飞 田见友 丁伟星 刘云松 张灿华 DU Ru-fei TIAN Jian-you DING ZHANG Can-hua Wei-xing LIU Yun-song(） Dept. of Anesthesiology, Second People＇s Hospital of Qujing ） Dept. of Anesthesiology, First People Hospital of Qujing, Qujing Yunnan 655000, China)

机构地区：[1]曲靖市第二人民医院麻醉科 [2]曲靖市第一人民医院麻醉科,云南曲靖655000

出　　处：《昆明医科大学学报》2016年第9期86-90,共5页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(81160035)

摘　　要：目的比较全麻和腰硬联合麻醉用于截瘫患者自主神经高反应手术的麻醉效果及安全性.方法将2011年02月至2015年11月26位截瘫患者随机分为对照组和治疗组各13例.对照组麻醉方式采用全麻,治疗组采用腰硬联合麻醉,观察2组麻醉的起效时间、持续时间、术中的血流动力学变化、并发症、住院天数及费用、病人及家属满意率.结果治疗组患者的麻醉剂用量与起效时间均要优于对照组.两组间差异有统计学意义(P<0.05);2组患者手术中与手术后,治疗组舒张压、收缩压及心率均低于对照组,有明显差异,有统计学意义(P<0.05);治疗组术中及术后并发症明显优于对照组患者,有统计学意义(P<0.05);2组患者的术后疼痛程度有显著差异有统计学意义(P<0.05);2组患者住院天数、住院费用、满意率差异有统计学意义(P<0.05).结论在截瘫患者自主神经高反应的手术中,腰硬联合麻醉的麻醉效果及安全性明显优于全麻,具有起效快、持续时间长并且术后并发症少、安全性高、患者对手术的满意度高等特点,值得在临床中进行推广应用.Objective To compare anesthetic effect and safety of general anesthesia and combined spinal and epidural anesthesia used in autonomic nervous hyperresponsive surgery for patients with paraplegia. Methods 26 paraplegic patients were randomly divided into two groupscontrol group and treatment group from February 2011 to November,2015,each with 13 cases. The control group used general anesthesia,while the treatment group used combined spinal and epidural anesthesia, to observe onset time, duration, intraoperative hemodynamic changes and complications, Complications, length of stay and cost,Days and costs of hospitalization,satisfaction of patients and their families,of anesthesia in two groups. Results The dosage of narcotics and the onset time of the treatment group were better than that of the control group.The difference between the two groups was significant,and had statistical significance（P〈0.05）.Two groups of patients after surgery,diastolic blood pressure,systolic blood pressure and heart rate were lower in the treatment group than in the control group,and had statistically significant difference（P〈0.05）;The postoperative complications of the treatment group were significantly better than those of the control group,and had statistically significant difference（P〈0.05）; There were statistically significant differences in postoperative pain degree between the two groups（P〈0.05）;Two groups of patients in hospital days,hospitalcosts,satisfaction rate had statistically significant difference,Have statistical significance（P〈0.05）. Conclusion In autonomic nervous hyperresponsive surgery for patients with paraplegia,anesthetic effect and safety of combined spinal and epidural anesthesia is significantly better than that of general anesthesia, featured by the rapid onset of action,long duration,fewer complications, strong safety and patients＇ great satisfaction. It is worth generalizing and applying clinically.

关 键 词：全麻 腰硬联合麻 截瘫患者自主神经高反应手术 

分 类 号：R614[医药卫生—麻醉学]