全麻复合硬膜外麻醉对老年腹腔镜手术患者应激反应指标、胃肠功能的影响  

Effects of general anesthesia combined with epidural anesthesia on stress response indexes and gastrointestinal function in elderly patients undergoing laparoscopic surgery

作　　者：张玉洁 张海罡 刘斌 ZHANG Yujie;ZHANG Haigang;LIU Bin(Anesthesiology Department,Chang'an University Hospital,Xi'an 710064;Anesthesiology Department,Xi'an XD Group Hospital,Xi'an 710077;Anesthesiology Department,Xi'an North Hospital,Xi'an 710032,China)

机构地区：[1]长安大学医院麻醉科,陕西西安710064 [2]西电集团医院麻醉科,陕西西安710077 [3]西安市北方医院麻醉科,陕西西安710032

出　　处：《临床医学研究与实践》2022年第17期128-131,共4页Clinical Research and Practice

摘　　要：目的分析全麻复合硬膜外麻醉对老年腹腔镜手术患者应激反应指标、胃肠功能的影响。方法选取2017年7月至2019年7月我院收治的96例行腹腔镜手术的老年患者为研究对象,根据抽签法将其分为对照组和观察组,各48例。对照组行全身麻醉,观察组行全麻复合硬膜外麻醉。比较两组患者的麻醉效果、应激反应指标、凝血功能指标及胃肠功能。结果观察组的拔管时间、睁眼时间和清醒时间均短于对照组(P<0.05)。麻醉后即刻和术毕,两组患者的肾上腺素、去甲肾上腺素、皮质醇水平均升高,但观察组低于对照组(P<0.05)。麻醉后即刻和术毕,观察组的凝血酶时间、凝血酶原时间和活化部分凝血酶原时间均长于对照组,且纤维蛋白原水平低于对照组(P<0.05)。观察组的排气时间、排便时间及进食流质食物时间均短于对照组(P<0.05)。结论全麻复合硬膜外麻醉应用在老年患者腹腔镜手术中可减轻应激反应,改善凝血功能,利于患者术后胃肠功能的恢复。Objective To analyze the effects of general anesthesia combined with epidural anesthesia on stress response indexes and gastrointestinal function in elderly patients undergoing laparoscopic surgery.Methods A total of 96 elderly patients who undergoing laparoscopic surgery treated in our hospital from July 2017 to July 2019 were selected as the research objects and divided into control group and observation group according to the method of drawing lots,with 48 cases in each group.The control group received general anesthesia,and the observation group received general anesthesia combined with epidural anesthesia.The anesthetic effect,stress response indexes,coagulation function indexes and gastrointestinal function were compared between the two groups.Results The extubation time,eye-opening time and wake-up time of the observation group were shorter than those of the control group(P<0.05).Immediately after anesthesia and after operation,the levels of epinephrine,norepinephrine and cortisol in the two groups increased,but those in the observation group were lower than the control group(P<0.05).Immediately after anesthesia and after operation,the thrombin time,prothrombin time and activated partial prothrombin time in the observation group were longer than those in the control group,and the level of fibrinogen was lower than that in the control group(P<0.05).The exhaust time,defecation time and the time of eating liquid food in the observation group were shorter than those in the control group(P<0.05).Conclusion The general anesthesia combined with epidural anesthesia applied in laparoscopic surgery for elderly patients can reduce stress response,and improve coagulation function,which is conducive to the recovery of gastrointestinal function of patients after operation.

关 键 词：全麻 硬膜外麻醉 腹腔镜手术 凝血功能 胃肠功能 

分 类 号：R614.2[医药卫生—麻醉学]