不同中医体质老年宫颈癌患者腹腔镜子宫切除术全麻复合硬膜外阻滞应激反应对比  

Comparison of stress response to general anesthesia combined with epidural block in laparoscopic hysterectomy for elderly patients with cervical cancer of different traditional Chinese medicine constitutions

作　　者：朱妮 张明强 屈强[1] ZHU Ni;ZHANG Ming-Qiang;QU Qiang(Department of Anesthesiology,Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610075,Sichuan,China)

机构地区：[1]成都中医药大学附属医院麻醉科,四川成都610075

出　　处：《中国老年学杂志》2023年第4期822-825,共4页Chinese Journal of Gerontology

基　　金：国家自然科学基金委员会青年科学基金项目(81701090)。

摘　　要：目的 对比不同中医(TCM)体质老年宫颈癌患者腹腔镜子宫切除术全麻复合硬膜外阻滞的应激反应。方法 前瞻性选择在全麻复合硬膜外阻滞麻醉下行腹腔镜子宫切除术治疗的105例老年宫颈癌患者作为研究对象。根据患者不同的中医体质分为阴虚质组、阳虚质组、平和质组,每组各35例。比较3组麻醉情况及麻醉前5 min(T0)、麻醉30 min时(T1)、术后6 h时(T2)应激反应指标[血清皮质醇(Cor)、肾上腺素(E)、血糖(Glu)]。结果 3组瑞芬太尼用量、丙泊酚用量、手术时间、苏醒时间比较,差异无统计学意义(P>0.05);3组T0时Cor、E、Glu比较,差异无统计学意义(P>0.05);T1时上述指标均升高,T2时降低,且T1、T2时点上述指标比较,阴虚质组最高,阳虚质组次之,平和质组最低,差异有统计学意义(P<0.05);3组组间、时点、组间时点交互比较,差异有统计学意义(P<0.05)。结论 不同中医体质老年宫颈癌患者全麻复合硬膜外阻滞下行腹腔镜子宫切除术的麻醉药物剂量、手术及苏醒时间并无差异,而术中及术后应激反应比较,阴虚质患者最重,阳虚质患者次之,平和质患者最轻。Objective To compare the stress response of laparoscopic hysterectomy under general anesthesia combined with epidural block in elderly patients with cervical cancer of different traditional Chinese medicine(TCM) constitutions.Methods 105 elderly patients with cervical cancer undergoing laparoscopic hysterectomy under general anesthesia combined with epidural anesthesia were prospectively selected as the study subjects. According to different TCM constitution of patients, they were divided into Yin deficiency group, Yang deficiency group and peace group, with 35 cases in each group. The anesthesia situation and stress reaction indexes [serum cortisol(Cor), adrenaline(E), blood glucose(Clu)] at 5 minutes before anesthesia(T0), 30 minutes after anesthesia(T1) and 6 hours after surgery were compared among the three groups. Results There was no statistical significant difference in remifentanil dosage, propofol dosage, operation time and recovery time among the three groups(P>0.05). There was no statistically significant difference in Cor, E and Clu among the three groups at T0(P>0.05), the above indexes increased at T1 and decreased at T2. Compared with above indexes at T1 and T2, the ones of the Yin deficiency group were the highest, followed by the Yang deficiency group, and the ones of the peace group were the lowest, with a statistically significant difference(P<0.05). There was a statistically significant difference among the three groups in terms of interaction between groups, group points and time points(P<0.05). Conclusions There is no difference in anesthetic dosage, operation and recovery time of laparoscopic hysterectomy under general anesthesia combined with epidural block in elderly patients with cervical cancer of different TCM constitutions. Compared with the stress reaction during and after operation, patients with Yin deficiency are the most serious, followed by patients with Yang deficiency, and patients with peace are the least serious.

关 键 词：宫颈癌 腹腔镜子宫切除术 全麻复合硬膜外阻滞 中医体质 应激反应 

分 类 号：R737.33[医药卫生—肿瘤] R713.42[医药卫生—临床医学]