不同麻醉方式对老年结直肠癌腹腔镜手术快速康复的影响  

Effects of Different Anesthesia on Rapid Rehabilitation of Laparoscopic Surgery in Colorectal

作　　者：温力生[1] 谭秀珍 闫志兵[1] 李瑞周 

机构地区：[1]江门市中心医院,广东江门529000

出　　处：《深圳中西医结合杂志》2017年第19期7-10,共4页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的;探讨评价麻醉深度监测仪监测下不同麻醉方式对老年结直肠癌患者腹腔镜手术快速康复的影响。方法:选取2013年6月至2015年6月江门市中心医院结直肠癌老年患者共60例,均拟行麻醉下手术。分别采用不同麻醉方式:七氟醚加瑞芬太尼S组(20例),丙泊酚加瑞芬太尼P组(20例),丙泊酚加七氟醚加瑞芬太尼平衡麻醉B组(20例),手术前及复苏拨管后30 min行血气分析对比血糖、血乳酸,记录麻醉深度监测仪监测过程中动脉血压、体温、心率、血氧饱和度、脑电双频指数(BIS),于术前1 d、术后第1、2、7 d,用精神状态量表(MMSE)评分进行评价。结果:患者术后第1、2、7 d与手术前比较,MMSE评分明显下降(P<0.05),各组间比较,B组明显高于S组、P组,差异有统计学意义(P<0.05),而S组与P组比较,差异无统计学意义(P>0.05)。与手术前比较,三种麻醉方式的心率、动脉血压、血氧饱和度、体温值均降低,BIS、血糖、全血乳酸均升高,差异具有统计学意义(P<0.05);S组、P组的心率、BIS、动脉血压、血氧饱和度、体温值均低于B组,组间比较,差异具有统计学意义(P<0.05);血糖、全血乳酸与B组比较,差异无统计学意义(P>0.05),S组与P组各项指标比较,差异无统计学意义(P>0.05)。结论:老年结直肠癌患者腹腔镜手术中采取丙泊酚加瑞芬太尼加七氟醚平衡麻醉,有利于维持人体循环稳定,有利于术后快速康复。Objective To investigate the evaluation of monitoring depth of anesthesia was monitored under different anesthesia application results in elderly patients with colorectal cancer laparoscopic surgery. Methods Included from June 2013 to June 2015 in our hospital undergoing anesthesia in elderly patients with a total of 60 cases. Using different anesthesia： Sevoflurane Jiarui S fentanyl group（20 cases）, propofol and fentanyl Jiarui P group（20 cases）, propofol plus fentanyl Jiarui balance sevoflurane anesthesia group B（20 patients）, surgery and recovery before extubation 30 min gas analysis comparing blood glucose, blood lactate and recording monitoring depth of anesthesia was monitored during bispectral index（BIS）, arterial blood pressure, heart rate, oxygen saturation, body temperature, and the day before surgery, postoperative day 1, 2 and 7 days, with MMSE scores were evaluated. Results 1,2,7 days after surgery compared with before surgery, MMSE score was significantly decreased（P〈0.05）, among the group, group B was significantly higher than S group, P group, the difference was statistically significant（P〈0.05）, while the S group and P group, the difference was not statistically significant（P〈0.05）. Compared with before surgery, BIS, arterial blood pressure, oxygen saturation, body temperature value of three different anesthesia methods are reduced, blood sugar, blood lactate were increased（P〈0.05）; S group, BIS P group, arterial blood pressure, oxygen saturation, body temperature were lower than in group B（P〈0.05）; blood glucose, blood lactic acid in group B was no difference between hospitals（P〈0.05）, S group and P group indexes, the difference was not statistically significant（P〉0.05）. Conclusion Laparoscopic surgery of colorectal cancer in elderly patients taking propofol Jiarui Fen balance too Dominican sevoflurane anesthesia to help maintain the human circulatory stability, conducive to rapid postoperative recovery, has a good prospect of clinical

关 键 词：直肠癌 腹腔镜术 丙泊酚 瑞芬太尼 七氟醚 平衡麻醉 老年人 

分 类 号：R614.23[医药卫生—麻醉学]