全麻复合硬膜外麻醉在老年直肠癌腹腔镜手术治疗中的应用  

Application of General Anesthesia Combined with Epidural Anesthesia inthe Laparoscopic Surgical Treatment of Rectal Cancer in the Elderly

作　　者：穆玉强 MU Yuqiang(Department of Anesthesiology,Linqing People's Hospital,Liaocheng,Shandong Province,252600 China)

机构地区：[1]临清市人民医院麻醉科,山东聊城252600

出　　处：《中外医疗》2023年第1期95-99,共5页China & Foreign Medical Treatment

摘　　要：目的 分析全麻复合硬膜外麻醉在老年直肠癌腹腔镜手术治疗中的应用效果。方法 采用方便抽样的方式将临清市人民医院于2020年1月—2022年1月收治的90例老年直肠癌患者作为研究对象,所有患者接受腹腔镜手术治疗,根据麻醉方案的不同分为两组,各45例。对照组实施全身麻醉,研究组实施全麻复合硬膜外麻醉。比较两组患者术前、切皮时、气腹20 min以及术毕时心率与平均动脉压水平,比较两组患者拔管时间、苏醒时间、简易智能精神状态检查量表(MMSE)评分,以及不良反应发生率。结果 研究组患者除术前外,其余时间点心率以及平均动脉压水平均低于对照组,差异有统计学意义(P<0.05)。与对照组相比,研究组患者拔管时间和苏醒时间更早,MMSE评分更低,差异有统计学意义(P<0.05);研究组患者不良反应发生率2.22%低于对照组17.78%,差异有统计学意义(χ^(2)=4.444,P<0.05)。结论 在老年直肠癌腹腔镜手术治疗中,应用全麻复合硬膜外麻醉能够有更好的麻醉效果,对患者心脏功能影响较小,安全性症更高。Objective To analyze the effect of general anesthesia compound epidural anesthesia in the laparoscopic surgical treatment of rectal cancer in the elderly.Methods 90 elderly patients with rectal cancer admitted to the Linq⁃ing People's Hospital from January 2020 to January 2022 were included in this study by convenience sampling.All patients were treated with laparoscopic surgery in the hospital,and were divided into two groups with 45 patients in each group according to different anesthesia protocol.General anesthesia was administered to the control group,and general anesthesia with epidural anesthesia was administered to the study group.The heart rate and mean arterial pres⁃sure levels were compared between the two groups before surgery,during skin incision,20 min of pneumoperitoneum,and at the end of surgery.The time to extubation,time to awakening,Simple Mental State Examination Scale(MMSE)scores and the incidence of adverse reactions in the two groups were compared.Results The heart rate and mean arte⁃rial pressure levels of the patients in the study group were lower than those in the control group,except for the preop⁃erative period,the difference was statistically significant(P<0.05).Compared with the control group,the study group had earlier extubation time and awakening time,lower MMSE scores,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the study group 2.22%was lower than that in the control group 17.78%,and the difference was statistically significant(χ^(2)=4.444,P<0.05).Conclusion In the treatment of laparoscopic sur⁃gery for rectal cancer in the elderly,the application of general anesthesia combined with epidural anesthesia can have a better anesthetic effect,with less impact on the patient's cardiac function and higher safety syndrome.

关 键 词：直肠癌 硬膜外麻醉 全身麻醉 腹腔镜 心率 动脉压 

分 类 号：R614[医药卫生—麻醉学]