两种麻醉方式联合在胃十二指肠穿孔手术患者中的应用  

Combined Use of Two Anesthesia Methods in the Surgery for Gastroduodenal Perforation

作　　者：高保双 GAO Baoshuang(Department of Anesthesia,Tianjin Ninghe District Hospital,Tianjin 301500,China)

机构地区：[1]天津市宁河区医院麻醉科,天津301500

出　　处：《中国医药导刊》2023年第9期957-961,共5页Chinese Journal of Medicinal Guide

摘　　要：目的:分析在为胃十二指肠穿孔手术患者实施麻醉过程中全身麻醉联合硬膜外阻滞麻醉的临床麻醉效果。方法:选取我院接受胃十二指肠穿孔手术治疗的150例患者作为研究对象,根据患者麻醉意愿的不同将其分为实验组(n=75)与参照组(n=75),参照组患者予以全身麻醉,实验组患者予以全身麻醉联合硬膜外阻滞麻醉。分析两组患者手术中的心率、平均动脉压,以及术后恢复自主呼吸、睁眼、拔管时间,苏醒评分,拔管后10 min疼痛评分和不良反应(头晕、恶心、心动过速)发生率,探讨胃十二指肠溃疡穿孔手术患者实施麻醉过程中全身麻醉联合硬膜外阻滞麻醉的临床麻醉效果。结果:麻醉诱导前,两组患者心率、平均动脉压差异均无统计学意义(P>0.05)。与参照组患者相比,实验组患者术中实施胃肠道探查时、拔除气管导管10 min后心率、平均动脉压指标差异均有统计学意义(P<0.05)。两组患者术后恢复自主呼吸、睁眼、拔管时间,苏醒评分以及拔管后10 min疼痛评分和不良反应发生率差异均有统计学意义(P<0.05)。结论:对于胃十二指肠穿孔手术患者,全身麻醉联合硬膜外阻滞麻醉是一种相对较为理想的麻醉方式。Objective:To analyze the clinical effects of general anesthesia combined with epidural block anesthesia in the surgery for gastroduodenal perforation.Methods:A total of 150 patients who underwent gastroduodenal perforation surgery in our hospital were selected as the research objects,and were divided into the experimental group(n=75)and the reference group(n=75)according to their different desire for anesthesia.Patients in the reference group received general anesthesia,and patients in the experimental group received general anesthesia combined with epidural block anesthesia.The heart rate,mean arterial pressure during the opertion,and postoperative spontaneous breathing time,eye opening time,extubation time,awakening score,pain score 10 minutes after extubation,and incidence of adverse reactions(dizziness,nausea,tachycardia)of the two groups of patitens were analyzed to investigate the clinical effect of general anesthesia combined with epidural block anesthesia in the process of anesthesia in patients undergoing surgery for gastroduodenal perforation.Results:Before anesthesia induction,there was no statistical significance in heart rate and mean arterial pressure between the two groups of patients(P>0.05).During gastrointestinal exploration and 10 min after tracheal catheter removal,the heart rate and mean arterial pressure of patients in the experimental group had statistical significance with those of the reference group(P<0.05).There were statistical significance in postoperative recovery time of spontaneous breathing,eye opening time,extubation time,awakening score,pain score 10 minutes after extubation and incidence of adverse reactions between the two groups(P<0.05).Conclusion:General anesthesia combined with epidural block anesthesia is a relatively ideal anesthesia method for patients undergoing surgery for gastroduodenal perforation.

关 键 词：麻醉方式 胃十二指肠穿孔 手术 苏醒评分 术后睁眼时间 疼痛评分 

分 类 号：R656.6[医药卫生—外科学]