腰-硬联合麻醉复合全麻对LAVH患者应激反应、认知功能及安全性的影响  

Effects of combined spinal-epidural anesthesia combined with general anesthesia on stress response,cognitive function and safety of patients with LAVH

作　　者：耿凤新 刘媛媛 GENG Fengxin;LIU Yuanyuan(Anesthesia Department of Operating Room,the People's Hospital of Hebi,Hebi 458030,China;Critical Care Medicine Department,the People's Hospital of Hebi,Hebi 458030,China)

机构地区：[1]河南省鹤壁市人民医院手术室麻醉科,河南鹤壁458030 [2]河南省鹤壁市人民医院重症医学科,河南鹤壁458030

出　　处：《临床医学研究与实践》2021年第7期99-101,共3页Clinical Research and Practice

摘　　要：目的探讨腰-硬联合麻醉复合全麻在腹腔镜辅助阴式子宫切除术(LAVH)患者中的应用效果。方法将80例LAVH患者依据麻醉方法分为复合麻醉组(n=40,腰-硬联合麻醉复合全麻)及单独全麻组(n=40,气管插管全麻)。比较两组的干预效果。结果复合麻醉组的干预优良率显著高于单独全麻组(P<0.05)。两组T_(1)、T_(2)、T_(3)、T_(4)时的HR均显著低于T_(0)时(P<0.05);复合麻醉组T_(1)、T_(2)、T_(3)、T_(4)、T_(5)时的MAP均显著低于T_(0)时(P<0.05);复合麻醉组T_(1)、T_(2)、T_(3)时的MAP均显著低于单独全麻组(P<0.05);单独全麻组T_(4)、T_(5)时的血浆E及Cor水平显著高于T_(0)时(P<0.05);复合麻醉组T_(4)、T_(5)时血浆E及Cor水平均显著低于单独全麻组(P<0.05)。复合麻醉组患者的认知功能障碍发生率及术后并发症总发生率显著低于单独全麻组(P<0.05)。结论腰-硬联合麻醉复合全麻更能有效调控LAVH患者的应激反应,减少患者认知功能障碍的发生,安全性较高。Objective To explore the application effect of combined spinal-epidural anesthesia combined with general anesthesia in patients with laparoscope-assisted vaginal hysterectomies(LAVH).Methods Eighty patients with LAVH were divided into compound anesthesia group(n=40,combined spinal-epidural anesthesia combined with general anesthesia)and single general anesthesia group(n=40,endotracheal intubation general anesthesia)according to anesthesia methods.The intervention effects of the two groups were compared.Results The excellent and good rate of intervention in the compound anesthesia group was significantly higher than that in the single general anesthesia group(P<0.05).The HR at T_(1),T_(2),T_(3) and T_(4) in both groups were significantly lower than that at T_(0)(P<0.05);MAP at T_(1),T_(2),T_(3),T_(4) and T_(5) in the compound anesthesia group were significantly lower than that at T_(0)(P<0.05);MAP at T_(1),T_(2) and T_(3) in the compound anesthesia group were significantly lower than that in the single general anesthesia group(P<0.05);the levels of plasma E and Cor at T_(4) and T_(5) in the single general anesthesia group were significantly higher than those at T_(0)(P<0.05);the levels of plasma E and Cor at T_(4) and T_(5) in the compound anesthesia group were significantly lower than those in the single general anesthesia group(P<0.05).The incidence of cognitive dysfunction and total incidence of postoperative complications in the compound anesthesia group were significantly lower than those in the single general anesthesia group(P<0.05).Conclusion Combined spinal-epidural anesthesia combined with general anesthesia can effectively regulate the stress response of patients with LAVH,reduce the occurrence of cognitive dysfunction,and has higher safety.

关 键 词：腹腔镜辅助阴式子宫切除术 腰-硬联合麻醉 全麻 

分 类 号：R614[医药卫生—麻醉学] R713.42[医药卫生—外科学]