胸段硬膜外麻醉与全麻复合应用对胸腔镜食管癌根治术患者胃肠功能与血电解质的影响  

Effect of Combined Application of Thoracic Epidural Anesthesia and General Anesthesia on Gastrointestinal Function and Blood Electrolytes in Patients Undergoing Thoracoscopic Radical Esophageal Cancer Surgery

作　　者：戚建伟 李凯 QI Jianwei;LI Kai(Department of Anesthesiology,Liaocheng Maternal and Child Health Hospital(Liaocheng Central Hospital),Liaocheng,Shandong Province,252000 China;Department of General Surgery,Liaocheng Veterans Hospital,Liaocheng,Shandong Province,252000 China)

机构地区：[1]聊城市妇幼保健院(聊城市中心医院)麻醉科,山东聊城252000 [2]聊城市退役军人医院普外科,山东聊城252000

出　　处：《世界复合医学》2021年第6期1-3,7,共4页World Journal of Complex Medicine

摘　　要：目的探讨胸段硬膜外麻醉与全麻复合应用对胸腔镜食管癌根治术患者胃肠功能与血电解质的影响。方法选择2017年8月—2020年7月于聊城市妇幼保健院暨聊城市中心医院行胸腔镜食管癌根治术的90例患者作为研究对象,以随机数表法将其分为两组。其中对照组45例行全麻下胸腔镜食管癌根治术,研究组45例行胸段硬膜外麻醉复合全麻下胸腔镜食管癌根治术。对比两组手术前与完成手术时的血电解质水平,以及术后胃肠功能情况。结果完成手术时,研究组血电解钠离子(142.6±3.5)mmol/L、钾离子(3.9±0.5)mmol/L水平均高于对照组(135.6±2.8)、(3.5±0.2)mmol/L,差异有统计学意义(t=10.476、4.983,P<0.001),氯离子水平(103.5±4.6)mmol/L低于对照组(110.5±5.2)mmol/L,差异有统计学意义(t=6.764,P<0.001)。研究组术后首次排气时间(45.2±5.3)h、首次进食时间(5.4±0.8)d与首次排便时间(45.2±5.3)h均低于对照组(55.6±6.0)h、(7.3±0.6)d、(60.5±4.9)h,差异有统计学意义(t=8.715、12.746、14.219,P<0.001)。结论胸段硬膜外麻醉与全麻复合应用于胸腔镜食管癌根治术中可以有效促进患者胃肠功能恢复,保障血电解质稳定性。Objective To investigate the effect of combined application of thoracic epidural anesthesia and general anesthesia on gastrointestinal function and blood electrolytes in patients undergoing thoracoscopic radical resection of esophageal cancer.Methods Ninety patients who underwent thoracoscopic radical esophageal cancer surgery in Liaocheng Matemal and Child Health Hospital and Liao cheng Central hospital from August 2017 to July 2020 were selected as the research objects,and they were divided into two groups by random number table method.Among them,45 patients in the control group underwent thoracoscopic radical esophageal cancer surgery under general anesthesia,and 45 patients in the study group underwent thoracic epidural anesthesia combined with general anesthesia under thoracoscope radical esophageal cancer radical surgery.The blood electrolyte levels before and at the completion of the operation and the gastrointestinal function after the operation were compared between the two groups.Results When the operation was completed,the blood electrolytic sodium ion(142.6±3.5)mmol/L and potassium ion(3.9±0.5)mmol/L in the study group were higher than those in the control group(135.6±2.8)mmol/L and(3.5±0.2)mmol/L,the difference was statistically significant(t=10.476,4.983,P<0.001),the chloride ion level(103.5±4.6)mmol/L was lower than the control group(110.5±5.2)mmol/L,the difference was statistically significant(t=6.764,P<0.001).The time of first exhaustion(45.2±5.3)h,the time of first eating(5.4±0.8)d and the time of first defecation(45.2±5.3)h in the study group were lower than those in the control group(55.6±6.0)h,(7.3±0.6)d,(60.5±4.9)h,the difference was statistically significant(t=8.715,12.746,14.219,P<0.001).Conclusion The combined application of thoracic epidural anesthesia and general anesthesia during thoracoscopic radical esophageal cancer surgery can effectively promote the recovery of gastrointestinal function and ensure the stability of blood electrolytes.

关 键 词：胸段硬膜外麻醉 全麻 胸腔镜食管癌根治术 胃肠功能 血电解质 

分 类 号：R614[医药卫生—麻醉学]