全身麻醉复合硬膜外麻醉对腹腔镜全子宫切除术患者应激反应与纤溶功能的影响  

Effects of General Anesthesia Combined with Epidural Anesthesia on Stress Response and Fibrinolytic Function in Patients Undergoing Laparoscopic Hysterectomy

作　　者：孟宪雷 MENG Xianlei(Department of Anesthesiology,Fengxian Hospital of Traditional Chinese Medicine,Fengxian,Jiangsu Province,221700 China)

机构地区：[1]丰县中医医院麻醉科,江苏丰县221700

出　　处：《中外医疗》2022年第14期52-55,共4页China & Foreign Medical Treatment

摘　　要：目的分析腹腔镜全子宫切除术中予以全身麻醉复合硬膜外麻醉对患者应激反应及纤溶功能的影响。方法方便选择2017年10月—2021年9月在该院接受腹腔镜全子宫切除术治疗的妇科患者67例,采取随机数表法将其分为两组,均接受腹腔镜全子宫切除术治疗。予以静脉全身麻醉的30例纳入对照组,予以全身麻醉复合硬膜外麻醉的37例纳入观察组。对比两组患者应激反应、纤溶功能及不良反应发生率。结果观察组拔管后及术后24 h心率、舒张压及收缩压指标水平为(79.25±4.77)次/min、(83.42±4.51)次/min、(77.56±4.59)mmHg、(84.87±3.26)mmHg、(122.05±8.75)mmHg、(127.55±7.68)mmHg,均优于对照组的(85.44±5.64)次/min、(91.55±5.03)次/min、(71.54±7.84)mmHg、(80.32±5.74)mmHg、(132.25±10.45)mmHg、(136.47±10.68)mmHg,差异有统计学意义(t=4.867、6.968、3.919、4.082、4.349、3.972,P<0.05)。观察组拔管后及术后24 h纤溶功能水平低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为2.70%,低于对照组的23.33%,差异有统计学意义(χ^(2)=4.888,P<0.05)。结论全身麻醉复合硬膜外麻醉用于腹腔镜全子宫切除术治疗中效果显著,手术应激反应及纤溶功能影响较小,安全性较高。Objective To analyze the effect of general anesthesia combined with epidural anesthesia on the stress response and fibrinolytic function of patients during laparoscopic total hysterectomy.Methods A total of 67 gynecological patients who received laparoscopic hysterectomy in the hospital from October 2017 to September 2021 were conveniently selected and divided into two groups by random number table method,both of whom received laparoscopic hysterectomy.30 patients who received intravenous general anesthesia were included in the control group,and 37 patients who received general anesthesia combined with epidural anesthesia were included in the observation group.The stress response,fibrinolytic function and the incidence of adverse reactions were compared between the two groups.Results The index levels of heart rate,diastolic blood pressure and systolic blood pressure in the observation group after extubation and 24 h after operation were(79.25±4.77)times/min,(83.42±4.51)times/min,(77.56±4.59)mmHg,(84.87±3.26)mmHg,(122.05±8.75)mmHg,(127.55±7.68)mmHg,all better than the control group(85.44±5.64)times/min,(91.55±5.03)times/min,(71.54±7.84)mmHg,(80.32±5.74)mmHg,(132.25±10.45)mmHg,(136.47±10.68)mmHg,and the difference was statistically significant(t=4.867,6.968,3.919,4.082,4.349,3.972,P<0.05).The level of fibrinolytic function in the observation group after extubation and 24 h after operation was lower than that in the control group,and the difference was statistically significant(P<0.05).The total adverse reactions in the observation group accounted for 2.70%,which was lower than 23.33%of the control group,and the difference was statistically significant(χ^(2)=4.888,P<0.05).Conclusion General anesthesia combined with epidural anesthesia is effective in the treatment of laparoscopic total hysterectomy,and the surgical stress response and fibrinolytic function have little effect,and the safety is high.

关 键 词：腹腔镜全子宫切除术 全身麻醉 硬膜外麻醉 应激反应 纤溶功能 

分 类 号：R614[医药卫生—麻醉学]