宫腔镜子宫内膜息肉切术椎管内麻醉与静脉复合麻醉对患者生命体征、血流动力学和顺行性遗忘的影响  

Impact of the neuraxial anesthesia and the total intravenous anesthesia during the hysteroscopic endometrial polypectomy of patients on their vital signs,hemodynamics and anterograde amnesia

作　　者：孙盼盼 任传将 李利敏 SUN Panpan;REN Chuanjiang;LI Limin(Linquan County People's Hospital,Linquan,Anhui Province,236400;The Second People's Hospital of Fuyang,Anhui Province)

机构地区：[1]安徽省临泉县人民医院,236400 [2]安徽省阜阳市第二人民医院

出　　处：《中国计划生育学杂志》2025年第3期596-601,共6页Chinese Journal of Family Planning

摘　　要：目的:考察并比较椎管内麻醉和静脉复合麻醉在宫腔镜子宫内膜息肉切术对患者生命体征、血流动力学和顺行性遗忘的影响。方法:纳入2021年1月-2023年12月本院收治的接受宫腔镜子宫内膜息肉切术患者130例,随机分为对照组(椎管内麻醉)和观察组(静脉复合麻醉)各65例。记录两组麻醉时间、失血量、输血、手术时间、术后下床活动时间,插管前或麻醉开始前(T1)、插管后或注药后3min(T2)、切皮后即刻(T3)、手术结束时(T4)生命体征指标每搏输出量(SV)、左心室射血分数(EF)和心输出量(CO),围术期血流动力学血氧饱和度(SpO_(2))、心率(HR)、平均动脉压(MAP)、顺行性遗忘、临床疗效和不良反应。结果:两组失血量、输血情况无差异(P>0.05),观察组麻醉时间、失血量、输血、手术时间均少于对照组,术后下床活动时间早于对照组(P<0.05)。T1,两组SV、EF、CO、SpO_(2)、HR、MAP无差异(P>0.05),T2~T4两组SV、EF、CO、SpO_(2)、HR、MAP均比T1不同程度降低但观察组变化幅度小于对照组(均P<0.05),观察组完全遗忘占比(93.9%)高于对照组(4.6%)(P<0.05)。两组术后总有效率、总不良反应均无差异(P>0.05)。结论:椎管内麻醉和静脉复合麻醉均可用于宫腔镜子宫内膜息肉切术,两者的有效性和安全性相当,但椎管内麻醉对患者的顺行性遗忘影响较小,静脉复合麻醉有助于稳定患者生命体征、血流动力学。Objective:To investigate and compare the impact of the neuraxial anesthesia and the total intravenous anesthesia during the hysteroscopic endometrial polypectomy of patients on their vital signs,hemodynamics and anterograde amnesia.Methods:A total of 130 patients with endometrial polyps who wanted hysteroscopic polypectomy were selected and were randomly divided into the control group(65 patients had received the neuraxial anesthesia)and the observation group(65 patients had received the total intravenous anesthesia)from January 2021 to December 2023.The anesthesia time,the blood loss,the transfusion situation,the operation time,and the time postoperative getting out of bed,the values of intraoperative vital signs,such as stroke volume(SV),left ventricular ejection fraction(EF)and cardiac output(CO),and the values of hemodynamics,such as SpO_(2),heart rate(HR)and mean arterial pressure(MAP),at T1(before intubation or the start of anesthesia),at T2(3 minutes after intubation or drug administration),at T3(immediately after skin incision)and at T4(at the end of surgery),the anterograde amnesia,the clinical efficacy and the adverse reactions of the patients in the two groups were recorded.Results:There was no significant difference in the blood loss and the blood transfusion of the patients between the two groups(P>0.05).The anesthesia time,the blood loss,the blood transfusion and the operation time of the patients in the observation group wer significantly less than those of the patients in the control group.The time of getting out of bed after operation of the patients in the observation group was significantly earlier than that of the patients in the control group(P<0.05).At T1,there were no significant differences in the values of SV,EF,CO,SpO_(2),HR and MAP of the patients between the two groups(P>0.05).At T2-T4,the values of SV,EF,CO,SpO_(2),HR and MAP of the patients in the two groups were significantly lower than those at T1 in the varying degree,but the changes of which of the patients in the observation gro

关 键 词：宫腔镜子宫内膜息肉切术 椎管内麻醉 静脉复合麻醉 生命体征 血流动力学 顺行性遗忘 不良反应 

分 类 号：R61[医药卫生—外科学]