全身麻醉复合硬膜外阻滞对行腹腔镜手术老年直肠癌患者的影响研究  

General anesthesia combined epidural block in laparoscopy for elderly patients with rectal cancer

作　　者：齐英军 冯英博 QI Yingjun;FENG Yingbo(Operating Room,Shenyang Anorectal Hospital,Shenyang 110001,Liaoning,China)

机构地区：[1]沈阳市肛肠医院手术室,沈阳110001

出　　处：《癌症进展》2021年第1期85-87,共3页Oncology Progress

摘　　要：目的探讨全身麻醉复合硬膜外阻滞对接受腹腔镜手术治疗的老年直肠癌患者的影响。方法将70例行腹腔镜手术的老年直肠癌患者随机分为对照组及观察组,每组35例。对照组给予气管插管全身麻醉,观察组在此基础上,复合硬膜外阻滞麻醉,分别在术前、麻醉复苏前、术后第1天,对比两组患者胰岛素抵抗指数(IR)、血糖(BS)、肾上腺素(AD)、血清皮质醇(Cor)水平;另外比较两组患者不良反应发生情况。结果术前两组患者IR、BS、AD、Cor水平比较,差异均无统计学意义(P﹥0.05);麻醉复苏前及术后,两组患者IR、BS、AD、Cor水平均升高(P﹤0.05),但观察组各指标均低于对照组,差异均有统计学意义(P﹤0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P﹤0.05)。结论针对老年直肠癌患者,在腹腔镜手术中实施全身麻醉复合硬膜外阻滞麻醉,能减轻其应激反应,有利于减少手术创伤以及不良反应。Objective To explore the clinical effect of general anesthesia combined epidural block in laparoscopy for elderly patients with rectal cancer.Method A total of 70 elderly patients with rectal cancer who received laparoscopic surgery were randomly divided into the control group and observation group(each n=35).The patients in the control group were given tracheal intubation general anesthesia.The patients in observation group were given combined epidural block anesthesia based on the treatment in the control group.The insulin resistance index(IR),blood sugar(BS),adrenaline(AD),serum cortisol(Cor)before surgery,before anesthesia recovery,and 1 day after surgery were compared,and the incidence of adverse reactions between the two groups was compared.Result There were no significant differences for the IR,BS,AD,and Cor between the two groups before surgery(P>0.05).The IR,BS,AD,and Cor increased in both groups before anesthesia recovery and after surgery,with significantly lower parameters and adverse reactions in the observation group than those in the control group(P<0.05).Conclusion The general anesthesia combined epidural block during laparoscopic surgery in eldly patients with rectal cancer can reduce the stress response,which can help reduce surgical trauma and adverse reactions.

关 键 词：腹腔镜 直肠癌 老年 全身麻醉 硬膜外阻滞麻醉 

分 类 号：R735.3[医药卫生—肿瘤]