连续硬膜外麻醉对老年腹腔镜阑尾切除术患者的影响  

Effect of Continuous Epidural Anesthesia on Elderly Patients Undergoing Laparoscopic Appendectomy

作　　者：陈林 李立芊[1] CHEN Lin;LI Liqian(Fuzhou First Hospital,Fuzhou 350009,China)

机构地区：[1]福州市第一医院,福建福州350009

出　　处：《中外医学研究》2021年第30期178-180,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨连续硬膜外麻醉对老年急性阑尾炎患者腹腔镜阑尾切除术后的影响。方法:选取本院2019年1月-2020年8月收治的需要进行腹腔镜阑尾切除术的老年患者150例为研究对象,根据随机数字表法分为观察组和对照组,各75例。对照组采用全身麻醉的方式进行腹腔镜阑尾切除术,观察组则采用连续硬膜外麻醉的方式进行手术。观察两组术后肠胃功能恢复时间、下床活动时间、住院时间、并发症发生情况及术前、术后1、2、3 d的VAS评分,测定术前、术后血清TNF-α、CRP的水平。结果:观察组肠胃功能恢复时间、下床活动时间、住院时间优于对照组,术后1、2、3 d观察组的VAS评分低于对照组,术后观察组血清TNF-α、CRP水平低于对照组,观察组并发症发生率低于对照组,差异均有统计学意义(P<0.05)。结论:老年急性阑尾炎患者行腹腔镜阑尾切除术时采用连续硬膜外麻醉的方式可以显著地降低并发症发生率,并且可以显著地减轻患者的疼痛感,降低术后患者的血清TNF-α、CRP水平,促进机体的快速康复,值得临床推广使用。Objective:To investigate the effects of continuous epidural anesthesia on elderly patients with acute appendicitis after laparoscopic appendectomy.Method:A total of 150 elderly patients needed laparoscopic appendectomy admitted to our hospital from January 2019 to August 2020 were selected as the research objects.They were divided into the observation group and the control group according to the random number table method,75 cases in each group.The control group used general anesthesia for laparoscopic appendectomy,and the observation group used continuous epidural anesthesia for surgery.The recovery time of gastrointestinal function,the time of getting out of bed,and hospital stay,the incidence of complications after the operation,the VAS scores before and 1,2,3 d after operation were observed,and the levels of serum TNF-αand CRP were determined before and after operation.Result:The time of gastrointestinal function recovery,the time of getting out of bed,the time of hospital stay in the observation group were better than those in the control group,the VAS scores postoperative 1,2 and 3 days of the observation group were lower than those in the control group,the levels of TNF-α,CRP in the observation group were lower than those in the control group,and the incidence of complications in the observation group was lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion:In elderly patients with acute appendicitis,the use of continuous epidural anesthesia during laparoscopic appendectomy can significantly reduce the incidence of complications,and can significantly relieve the pain of patients,and reduce the levels of serum TNF-αand CRP of patients after operation,promote the rapid recovery of the body.It is worthy of clinical application.

关 键 词：连续硬膜外麻醉 急性阑尾炎 腹腔镜阑尾切除术 

分 类 号：R614[医药卫生—麻醉学]