硬膜外复合全身麻醉及硬膜外镇痛在胃肠道手术术后快通道恢复中的临床研究  

Clinical Study of Epidural Combined with General Anesthesia and Epidural Analgesia on the Recovery of Fast Track after Gastrointestinal Surgery

作　　者：叶衍德 YE Yande(Second Hospital,Nanping City,Nanping 354200,China)

机构地区：[1]南平市第二医院,福建南平354200

出　　处：《中外医学研究》2020年第24期45-47,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:对行胃肠道手术患者应用硬膜外复合全身麻醉+硬膜外镇痛对术后快通道恢复的效果进行分析。方法:选取2018年1月-2019年1月于笔者所在医院接受胃肠道手术治疗的90例患者进行观察,随机分为对照组及研究组,分别给予全身麻醉及硬膜外复合全身麻醉+硬膜外镇痛,记录两组术后疼痛评分、胃肠功能恢复情况及不良反应发生率。结果:研究组术后2、6、12 h疼痛评分分别为(2.1±0.8)、(2.6±1.1)、(2.3±1.0)分,均明显低于对照组的(3.7±1.2)、(4.2±1.3)、(3.3±1.1)分,差异有统计学意义(P<0.05);研究组肠鸣音恢复时间、排气时间、首次进食时间及排便时间分别为(32.6±5.2)h、(43.8±5.2)h、(3.8±0.6)d、(48.3±4.8)h,均显著早于对照组的(47.4±6.0)h、(60.4±5.8)h、(5.1±1.0)d、(58.7±5.1)h,差异均有统计学意义(P<0.05);研究组胃肠不良反应发生率(4.44%)低于对照组(22.22%),差异有统计学意义(P<0.05)。结论:对行胃肠道手术患者应用硬膜外复合全身麻醉+硬膜外镇痛的效果显著,对降低手术刺激引起的应激反应、加速术后胃肠功能恢复具有积极意义,且术后恶心呕吐及腹胀等不良反应发生率较低,值得在胃肠道手术中推广应用。Objective:To analyze the effect of epidural combined with general anesthesia and epidural analgesia on the recovery of fast track after gastrointestinal surgery.Method:A total of 90 patients undergoing gastrointestinal surgery in our hospital from January 2018 to January 2019 were observed.The patients were randomly divided into the control group and the study group,and the general anesthesia and epidural combined with general anesthesia and epidural analgesia were given.And the pain scores after surgery,gastrointestinal function recovery and incidence of adverse reactions were recorded between the two groups.Result:The pain scores of the study group at 2,6 and 12 h after surgery were(2.1±0.8),(2.6±1.1),(2.3±1.0)points,which were significantly lower than(3.7±1.2),(4.2±1.3),(3.3±1.1)points of the control group,and the differences were statistically significant(P<0.05).The recovery time of bowel sounds,exhaust time,first feeding time and defecation time of the study group were respectively(32.6±5.2)and(43.8±5.2)h,(3.8±0.6)d and(48.3±4.8)h,which were significantly earlier than(47.4±6.0)and(60.4±5.8)h,(5.1±1.0)d and(58.7±5.1)h of the control group,and the differences were statistically significant(P<0.05).The incidence of gastrointestinal adverse reactions in the study group was 4.44%,which was lower than 22.22%of the control group,and the difference was statistically significant(P<0.05).Conclusion:The effect of epidural combined with general anesthesia and epidural analgesia in patients undergoing gastrointestinal surgery is obvious,which is of positive significance to reduce the stress response caused by surgical stimulation and accelerate the recovery of gastrointestinal function after surgery.Besides,the incidence of postoperative adverse reactions such as nausea,vomiting and abdominal distension is relatively low,which is worthy of popularization and application in gastrointestinal surgery.

关 键 词：胃肠道手术 全身麻醉 硬膜外麻醉 胃肠功能 快通道恢复 

分 类 号：R614[医药卫生—麻醉学]