骶管麻醉联合地西泮、阿托品预处理对择期吻合器痔上黏膜环切术患者生命体征、牵拉反射及疼痛的影响  

Effect of sacral anesthesia combined with diazepam and atropine pretreatment on the vital signs,stretch reflex and pain in patients undergoing elective procedure for prolapse and hemorrhoids

作　　者：李志刚[1] 于金辉[1] 李明颖[1] 王振元[1] LI Zhi-gang;YU Jin-hui;LI Ming-ying;WANG Zhen-yuan(Department of Anesthesiology, Beijing Chaoyang Hospital Affiliated to Capital Medical University （Western District）, Beijing 100043 ,China)

机构地区：[1]首都医科大学附属北京朝阳医院麻醉科(西区),北京100043

出　　处：《实用药物与临床》2018年第3期289-292,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的研究骶管麻醉联合地西泮、阿托品预处理对择期吻合器痔上黏膜环切术(Procedure for prolapse and hemorrhoids,PPH)患者生命体征、牵拉反射及疼痛的影响。方法选取2014至2016年行择期PPH术的患者104例,并应用区组随机的方法将患者分为观察组(52例)和对照组(52例)。观察组患者在PPH术术前1 h使用适量的地西泮、阿托品行预处理,对照组患者使用相同量的生理盐水行预处理,对所有患者行骶管麻醉以及PPH术,同时记录并分析两组患者的MAP、HR、SpO2、VAS评分、牵拉反射以及并发症发生率等。结果观察组患者行PPH术时的生命体征较对照组稳定(P<0.05);观察组患者行PPH术时的手术时间较对照组短(P<0.05);观察组患者行PPH术时的牵拉反射发生率较对照组降低(P<0.05);观察组患者行PPH术后的疼痛度较对照组减轻(P<0.05);观察组患者行PPH术后的并发症例数少于对照组(P<0.05)。结论对行PPH术患者在术前1 h行骶管麻醉联合地西泮、阿托品预处理,可以更加有效地降低PPH术中牵拉反射发生率,更好地控制患者生命体征,有利于患者术中的安全,而且其术后的并发症更低,有利于患者术后的康复,临床上宜大力推广。Objective To study the effect of sacral anesthesia combined with diazepam and atropine pretreatment on the vital signs,stretch reflex and pain in patients undergoing elective procedure for prolapse and hemorrhoids（PPH）.Methods A total of 104 patients undergoing elective PPH were selected who were treated in our hospital from2014 to 2016,and according to the block randomization method,104 patients were divided into observation group（n =52） and control group（n = 52）.The patients in observation group was pretreated with right amount of diazepam and atropine1 h before PPH,and the patients in control group were pretreated with the same amount of normal saline.Then the sacral canal anesthesia and PPH operation were performed in all patients.At the same time,the MAP,HR,SpO2,degree of pain,stretch reflex and the incidence of complications in the two groups were recorded and analyzed.Results The vital signs of the patients in observation group was more stable than that of control group during PPH（P 〈 0.05）;the operation time of PPH in observation group was shorter than that of control group（P 〈 0.05）,and the rate of stretch reflex in observation group was lower than that of control group during PPH（P 〈 0.05）;the degree of postoperative pain of observation group was less than that of control group after PPH（P 〈 0.05）;the postoperative complications of observation group were fewer than those of control group after PPH（P 〈 0.05）.Conclusion For PPH patients,one hour prior to surgery,the pretreatment with sacral anesthesia combined with diazepam and atropine can effectively reduce the incidence of stretch reflex during PPH and more effectively control the vital signs,which is conductive to the safety of patients during operation.Besides,its postoperative complications are fewer,which is conductive to the rehabilitation of patients after surgery.So it should be vigorously promoted in clinic.

关 键 词：骶管麻醉 地西泮 阿托品 吻合器痔上黏膜环切术 

分 类 号：R614[医药卫生—麻醉学]