探讨胸段硬膜外麻醉复合全身麻醉对胸腔镜食管癌根治术患者血电解质及胃肠道功能的影响  

Effect of thoracic epidural anesthesia combined with general anesthesia on blood electrolytes and gastrointestinal function in patients undergoing thoracoscopic radical esophagectomy

作　　者：罗绍君 LUO Shao-jun(Zhongxian County People's Hospital,Chongqing 404300,China)

机构地区：[1]忠县人民医院,404300

出　　处：《中国实用医药》2021年第12期22-24,共3页China Practical Medicine

摘　　要：目的探讨胸段硬膜外麻醉复合全身麻醉对胸腔镜食管癌根治术患者血电解质及胃肠道功能的影响。方法 60例行胸腔镜食管癌根治术患者,按照随机数字表法分为对照组与观察组,各30例。对照组实施全身麻醉,观察组实施胸段硬膜外麻醉复合全身麻醉。比较两组手术前后血电解质水平,入室后、麻醉后、手术开始30 min与手术完成时的心率、平均动脉压水平,术后开始排气、排便与进食时间,胃肠道不良反应发生率。结果手术后,观察组血钠(130.52±5.28)mmol/L与血氯(105.58±5.21)mmol/L低于对照组的(135.60±7.15)、(111.36±6.32)mmol/L,血钾(4.08±0.22)mmol/L高于对照组的(3.81±0.27)mmol/L,差异有统计学意义(P<0.05)。两组入室后、麻醉后、手术开始30 min与手术完成时的心率、平均动脉压比较差异无统计学意义(P>0.05)。观察组术后开始排气时间为(44.25±5.10)h、开始排便时间为(48.63±4.18)h、开始进食时间为(5.30±0.45)d,均短于对照组的(53.72±4.51)h、(61.50±5.84)h、(7.16±0.58)d,术后胃肠道不良反应发生率10.00%低于对照组的40.00%,差异有统计学意义(P<0.05)。结论胸段硬膜外麻醉复合全身麻醉可有效提升胸腔镜食管癌根治术患者血电解质稳定度,加快患者机体胃肠道功能恢复,减少胃肠道不良反应。Objective To discuss the effect of thoracic epidural anesthesia combined with general anesthesia on blood electrolytes and gastrointestinal function in patients undergoing thoracoscopic radical esophagectomy.Methods A total of 60 patients undergoing thoracoscopic radical esophagectomy were divided into control group and observation group according to random numerical table,with 30 cases in each group.The control group received general anesthesia,and the observation group received thoracic epidural anesthesia combined with general anesthesia.The blood electrolytes level before and after operation,heart rate and mean arterial pressure level after entering the operating room,after anesthesia,30 min from the beginning of operation and at the completion of operation,postoperative exhaust time,defecation time,and occurrence of gastrointestinal adverse reactions were compared between the two groups.Results After operation,the blood sodium(130.52±5.28)mmol/L and blood chlorine(105.58±5.21)mmol/L of the observation group were lower than(135.60±7.15)and(111.36±6.32)mmol/L of the control group,and blood potassium(4.08±0.22)mmol/L was higher than(3.81±0.27)mmol/L of the control group.All the difference was statistically significant(P<0.05).After entering the operating room,after anesthesia,30 min from the beginning of operation and at the completion of operation,there was no statistically significant difference in heart rate and mean arterial pressure between the two groups(P>0.05).The postoperative exhaust time,defecation time and feeding time of the observation group were(44.25±5.10)h,(48.63±4.18)h and(5.30±0.45)d,which were shorter than(53.72±4.51)h,(61.50±5.84)h and(7.16±0.58)d of the control group,and the incidence of gastrointestinal adverse reactions 10.00%was lower than 40.00%of the control group.All the difference was statistically significant(P<0.05).Conclusion Combination of thoracic epidural anesthesia and general anesthesia can effectively improve the electrolyte stability of patients with thoracosco

关 键 词：食管癌 胸段硬膜外麻醉 全身麻醉 血电解质 胃肠道功能 不良反应 

分 类 号：R614[医药卫生—麻醉学] R735.1[医药卫生—外科学]