CSEA和TIVA均在经皮肾镜碎石术麻醉中的应用效果对比  

Comparison of application effects of CSEA and TIVA in the anesthesia of percutaneous nephrolithotomy

作　　者：孙菲 宋玲 高桂芳 Sun Fei;Song Ling;Gao Guifang(Department of Anesthesiology, Shiyan Hospital of Integrated Traditional Chinese and Western Medicine, Shiyan,Hubei, 442000, China)

机构地区：[1]湖北省十堰市中西医结合医院麻醉科,湖北十堰442000

出　　处：《当代医学》2019年第14期101-103,共3页Contemporary Medicine

摘　　要：目的探究腰麻-硬膜外联合麻醉(CSEA)和全凭静脉麻醉(TIVA)在经皮肾镜碎石术(PCNL)麻醉中的应用效果比较。方法选取2017年7月至2018年7月收治本院治疗的肾结石患者40例,根据麻醉方式不同分组,采用CSEA为观察组(20例),采用TIVA为对照组(20例),观察入室时(t0)、改变体位时(t_1)、出室(t_2)、观察组腰麻后15 min(t_(15))、对照组气管插管时(t_i)患者心率(HR)、平均动脉压(MAP)及血氧饱和度(SpO_2)。结果观察组比对照组麻醉苏醒时间长(P<0.05),起效时间短(P<0.05),用药量少(P<0.05);t_1时观察组HR、MAP高于对照组(P<0.05);t_2时HR、MAP低于对照组(P<0.05),SpO_2高于对照组(P<0.05);观察组不良反应发生率为25.0%,对照组为65.0%,观察组显著低于对照组(P<0.05)。结论 CSEA与TIVA两种麻醉方法在PCNL手术中效果不同,应依据患者情况制定个体化麻醉方案。Objective To explore and compare the application effects of combined spinal-epidural anesthesia(CSEA) and total intravenous anesthesia(TIVA) in the anesthesia of percutaneous nephrolithotomy(PCNL). Methods 40 patients with renal calculi treated in the hospital from July 2017 to July 2018 were selected and grouped according to different anesthesia methods. Patients with CSEA were used as observation group(20 cases), and patients with TIVA were used as control group(20 cases). The heart rate(HR), mean arterial pressure(MAP) and blood oxygen saturation(SpO2) were observed at entering the room(t0), at time of body position change(t1), at exiting room(t2), at 15 min after spinal anesthesia(t15) in observation group and at tracheal intubation(ti) in control group. Results The anesthesia recovery time in observation group was longer than that in control group(P<0.05), and the onset time was shorter(P<0.05), and the dosage was less(P<0.05). At t1, the HR and MAP in observation group were higher than those in control group(P<0.05). At t2, the HR and MAP were lower than those in control group(P<0.05), and SpO2 was higher than that in control group(P<0.05). The incidence rate of adverse reactions was 25.0% in observation group and 65.0% in control group, and the incidence rate in observation group was significantly lower than that in control group(P<0.05). Conclusion The two anesthesia methods of CSEA and TIVA have different effects in PCNL surgery. It is necessary to develop individualized anesthesia regimen according to the condition of patients.

关 键 词：腰麻硬膜外联合麻醉 全凭静脉麻醉 经皮肾镜碎石术 

分 类 号：R614[医药卫生—麻醉学]