全身麻醉复合硬膜外麻醉在腹腔镜全子宫切除术中的应用观察  

Observation on the application of general anesthesia combined with epidural anesthesia in laparoscopic total hysterectomy

作　　者：么凯 Yao Kai(Fushun Maternal and Child Health Hospital,Fushun 113006,China)

机构地区：[1]辽宁省抚顺市妇幼保健院,113006

出　　处：《中国实用医药》2021年第19期41-44,共4页China Practical Medicine

摘　　要：目的探讨全身麻醉(全麻)复合硬膜外麻醉与单独应用全麻在腹腔镜全子宫切除术中的麻醉效果。方法122例行腹腔镜全子宫切除术患者,随机分为对照组与观察组,每组61例。对照组患者应用全麻,观察组患者应用全麻复合硬膜外麻醉。比较两组患者麻醉前(T0)、麻醉后10 min(T_(1))、拔管后(T_(2))及术后24 h(T_(3))时的心率、血压、血糖、D-二聚体及纤溶蛋白降解产物水平,自主呼吸恢复时间、拔管时间、清醒时间,不良反应发生情况。结果T0、T_(1)时,两组患者心率、收缩压、舒张压、血糖、D-二聚体及纤溶蛋白降解产物水平比较差异无统计学意义(P>0.05);T_(2)、T_(3)时,观察组患者心率、收缩压、舒张压、血糖、D-二聚体及纤溶蛋白降解产物水平均低于对照组,差异具有统计学意义(P<0.05)。观察组患者自主呼吸恢复时间、拔管时间及清醒时间分别为(3.17±2.56)、(6.39±3.01)、(9.73±5.12)min,明显短于对照组的(7.02±2.13)、(10.31±5.01)、(13.01±3.05)min,差异具有统计学意义(P<0.05)。观察组患者不良反应发生率为6.56%,明显低于对照组的19.67%,差异具有统计学意义(P<0.05)。结论全麻复合硬膜外麻醉应用于腹腔镜子宫全切除术患者中,可减轻患者应激反应,缩短患者自主呼吸恢复时间、拔管时间及清醒时间,降低不良反应发生率,利于患者早日康复。Objective To discuss the anesthetic effect of general anesthesia combined with epidural anesthesia in laparoscopic total hysterectomy.Methods A total of 122 patients undergoing laparoscopic total hysterectomy were randomly divided into control group and observation group,with 61 cases in each group.The control group was treated with general anesthesia,and the observation group was treated with general anesthesia combined with epidural anesthesia.The heart rate,blood pressure,blood glucose,D-dimer and fibrinolytic protein degradation product levels before anesthesia(T0),10 min after anesthesia(T_(1)),after extubation(T_(2))and 24 h after operation(T_(3)),recovery time of spontaneous breathing,extubation time,awake time,and occurrence of adverse reactions were compared between the two groups.Results At T0 and T_(1),there was no statistically significant difference in heart rate,blood pressure,blood glucose,D-dimer and fibrinolytic protein degradation product levels between the two groups(P>0.05).At T_(2) and T_(3),the heart rate,blood pressure,blood glucose,D-dimer and fibrinolytic protein degradation product levels of the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).The recovery time of spontaneous breathing,extubation time and awake time of the observation group were(3.17±2.56),(6.39±3.01),and(9.73±5.12)min,which were obviously shorter than(7.02±2.13),(10.31±5.01)and(13.01±3.05)min of the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions of the observation group was 6.56%,which was obviously lower than 19.67% of the control group,and the difference was statistically significant(P<0.05).Conclusion Application of general anesthesia and epidural anesthesia in patients undergoing laparoscopic total hysterectomy can reduce the patient’s stress response,shorten the patient’s recovery time of spontaneous breathing,extubation time and awake time,reduce the incidence of adverse reactio

关 键 词：全身麻醉 硬膜外麻醉 腹腔镜 全子宫切除 

分 类 号：R614[医药卫生—麻醉学]