子宫内膜癌腹腔镜下根治术患者采用全身麻醉复合硬膜外麻醉的效果及纤溶功能的影响  

Effect of general anesthesia combined with epidural anesthesia in laparoscopic radical surgery for endometrial cancer and its impact on fibrinolytic function

作　　者：王珍 韩小弟 WANG Zhen;HAN Xiaodi(Anesthesiology Department,Tianshui First People's Hospital,Tianshui 741000,China)

机构地区：[1]天水市第一人民医院麻醉科,甘肃天水741000

出　　处：《黑龙江医药科学》2025年第2期162-165,共4页Heilongjiang Medicine and Pharmacy

摘　　要：目的:探析全身麻醉复合硬膜外麻醉在子宫内膜癌腹腔镜下根治术中的价值。方法:选取2022年1月至2023年1月天水市第一人民医院收治的62例子宫内膜癌患者,随机分组,各31例。对照组予以静脉-吸入复合麻醉,观察组予以全身麻醉复合硬膜外麻醉。比较两组纤溶功能指标、血流动力学指标、不良反应发生率。结果:两组麻醉前纤溶指标水平比较无差异(P>0.05),观察组麻醉5 min、拔管后纤溶指标水平包括PAI-1、t-PA、D-D较对照组低,组间差异显著(P<0.05),两组患者T_(1)时血流动力学指标水平比较无差异(P>0.05),观察组患者T_(2)、T_(3)、T_(4)、T_(5)时MAP水平较对照组高、HR水平较对照组低(P<0.05),观察组不良反应发生率较对照组低(P<0.05)。结论:子宫内膜癌腹腔镜下根治术中全身麻醉复合硬膜外麻醉效果明显,患者机体纤溶功能指标明显下降,其血流动力学指标维持稳定,可降低不良反应发生。Objective:To explore the value of general anesthesia combined with epidural anesthesia in laparoscopic radical surgery for endometrial cancer.Methods:62 patients with endometrial cancer admitted to Tianshui First People's Hospital from January 2022 to January 2023 were randomly divided into two groups,with 31 patients in each group.The control group received intravenous-inhalation combined anesthesia,while the observation group received general anesthesia combined with epidural anesthesia.The fibrinolytic function indicators,hemodynamic indicators and incidence of adverse reactions were compared between the two groups.Results:There was no difference in fibrinolytic indicators between the two groups before anesthesia(P>0.05).The fibrinolytic indicators including PAI-1,t-PA,and D-D in the observation group were lower than those in the control group at 5 minutes after anesthesia and after extubation,with significant differences between the groups(P<0.05).There was no difference in hemodynamic indicators between the two groups at T_(1)(P>0.05).The MAP levels in the observation group were higher and the HR levels were lower than those in the control group at T_(2),T_(3),T_(4) and T_(5)(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion:General anesthesia combined with epidural anesthesia in laparoscopic radical surgery for endometrial cancer has a significant effect,with a notable decrease in fibrinolytic function indicators,stable hemodynamic indicators and a reduction in adverse reactions.

关 键 词：子宫内膜癌 腹腔镜下根治术 全身麻醉 硬膜外麻醉 纤溶功能 

分 类 号：R737.33[医药卫生—肿瘤] R614[医药卫生—临床医学]