不同麻醉方式对吻合器痔上黏膜环切术日间手术快速康复的影响  

Effects of different anesthesia methods on rapid recovery of day surgery after procedure for prolapse and hemorrhoids

作　　者：何翠翠 董庆龙[1] 梁丽霞[1] 陈劲松[2] He Cuicui;Dong Qinglong;Liang Lixia;Chen Jinsong(Department of Anesthesiology,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China;Department of Gastrointntestinal Surgery,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China)

机构地区：[1]广州医科大学附属第一医院麻醉科,510120 [2]广州医科大学附属第一医院胃肠外科,510120

出　　处：《中华普通外科学文献（电子版）》2021年第3期193-197,共5页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的探讨适合吻合器痔上黏膜环切术(PPH)最优麻醉方式,从而促进患者术后快速康复。方法选取2019年7月至2020年1月广州医科大学附属第一医院择期行PPH的患者60例,随机分成腰硬联合麻醉组(A组)、肌肉松弛药喉罩通气全身麻醉+肛周阻滞组(B组)、无肌肉松弛药喉罩通气全身麻醉+肛周阻滞组(C组),每组20例。比较三组患者围术期麻醉效果:每组术前、术中、手术结束的血压、心率变化,手术时间,拔除喉罩时间;患者术后2、6、12、24 h疼痛评分和镇痛药使用率;患者术后尿潴留发生率、住院时间和术后睡眠情况。结果B组的麻醉效果明显优于A组和C组(P<0.05);术后镇痛评分和镇痛药使用率均低于A组和C组(P<0.05);尿潴留发生率、住院时间明显低于A组和C组;术后睡眠质量优于A组和C组(P<0.05)。结论肌肉松弛药喉罩通气全身麻醉+肛周阻滞更适合PPH日间手术,麻醉效果优,有效降低患者术后疼痛程度,尿潴留发生率明显下降,患者术后康复快,值得推广。Objective To explore the optimal anesthesia procedure for prolapse and hemorrhoids(PPH),so as to promote the rapid recovery of patients.Methods 60 patients with PPH in the First Affiliated Hospital of Guangzhou Medical University from July 2019 to January 2020 were randomly divided into combined spinal epidural anesthesia(group A),laryngeal mask airway(LMA)with muscle relaxant(group B)and general anesthesia with non muscle relaxant laryngeal mask airway(group C),with 20 cases in each group.The perioperative anesthesia effects of the three groups were compared:the changes of blood pressure and heart rate before operation,during operation and at the end of operation,the operation time and the time of removing laryngeal mask in each group.Postoperative pain score and analgesic use rate at 2,6,12 and 24 h,and the incidence of postoperative urinary retention,hospital stay and postoperative sleeping were recorded.Results The anesthetic effect in group B was significantly better than that in group A and group C(P<0.05).Postoperative analgesia scores of group B at 2,6,12 and 24 h were lower than those of group A and C(P<0.05).The incidence of urinary retention and the length of hospital stay in group B was significantly lower than that in group A and C.The sleep quality of group B was better than that of group A and group C(P<0.05).Conclusions Muscle relaxation LMA ventilation general anesthesia+perianal block is more suitable for PPH day surgery.The effect of anesthesia is excellent,which can reduce postoperative pain and reduce the incidence of urinary retention.

关 键 词：麻醉 快速康复 日间手术 PPH 

分 类 号：R614[医药卫生—麻醉学]