硬膜外复合全身麻醉对老年结肠癌根治术对患者临床指标及肺功能的影响  

Effect of epidural combined general anesthesia on clinical indexes and lung function in elderly patients undergoing radical resection of colon cancer

作　　者：杨杜标[1] 李颖[1] 孔莉[1] YANG Du-biao;LI Ying;KONG Li(Department of Anesthesiology,the First People's Hospital of Shangqiu,Shangqiu,Henan 476100,China)

机构地区：[1]商丘市第一人民医院麻醉科,河南商丘476100

出　　处：《医药论坛杂志》2025年第3期302-306,共5页Journal of Medical Forum

摘　　要：目的探讨老年结肠癌根治术中行硬膜外阻滞麻醉复合全身麻醉的术中出血量、术中平均动脉压、术中心率和手术操作、麻醉诱导、麻醉维持、麻醉苏醒及恢复自主呼吸时间和对肺功能的影响。方法选择2020年1月至2022年4月于商丘市第一人民医院行结肠癌根治术治疗的86例老年患者为观察对象,按麻醉方式不同分成对照组(n=43)与观察组(n=43)。对照组采取全身麻醉干预,观察组采用硬膜外阻滞麻醉复合全身麻醉。对比两组临床指标、肺功能[每分钟最大通气量(maximum volume per minute,MVV)、用力呼气容积(forced expiratory volume,FVC)及第1s用力呼气容积(1s forced expiratory volume,FEV1)]、术后康复效果、术后并发症的发生率。结果两组手术及麻醉诱导时间、术中出血量、麻醉维持时间对比差异无统计学意义(P>0.05);观察组麻醉苏醒及恢复自主呼吸时间为(8.70±2.16)min和(6.22±1.97)h,短于对照组的(12.89±3.41)min和(14.43±2.11)h,差异有统计学意义(P<0.05);两组术前MVV、FVC、FEV1对比差异无统计学意义(P>0.05);对比术前,两组术后3 d的MVV、FVC、FEV1水平均降低,观察组分别为(76.34±4.42)、(77.79±5.24)及(80.23±7.7),高于对照组,差异有统计学意义(P<0.05);观察组术后各指标均优于对照组,差异有统计学意义(P<0.05);观察组术后并发症的发生率11.63%,低于对照组的30.23%,差异有统计学意义(P<0.05)。结论在老年结肠癌根治术患者中采用硬膜外复合全身麻醉效果确切,能确保手术顺利开展,减轻对肺功能影响,缩短术后麻醉苏醒时间、术后恢复时间,且安全性更高,可于临床推广。Objective To investigate the effects of epidural anesthesia combined with general anesthesia on intraoperative blood loss,intraoperative mean arterial pressure,intraoperative heart rate,surgical procedures,anesthesia induction,anesthesia maintenance,anesthesia emergence and recovery of spontaneous breathing time and pulmonary function in elderly patients undergoing radical resection of colon cancer.Methods A total of 86 elderly patients who underwent radical operation for colon cancer in the First People's Hospital of Shangqiu from January 2020 to April 2022 were selected as the observation subjects,and divided into control group(n=43)and observation group(n=43)according to different anesthesia methods.The control group received general anesthesia,and the observation group received epidural block anesthesia combined with general anesthesia.The clinical indexes,pulmonary function[maximum volume per minute(MVV),forced expiratory volume(FVC)and 1s forced expiratory volume(FEV1)],postoperative rehabilitation effect and incidence of postoperative complications were compared between the two groups.Results There was no significant difference in operation and anesthesia induction time,intraoperative blood loss and anesthesia maintenance time between the two groups(P>0.05).The time of anesthesia recovery and spontaneous breathing in the observation group were(8.70±2.16)min and(6.22±1.97)h,which were shorter than those in the control group(12.89±3.41)min and(14.43±2.11)h(P<0.05).There was no statistical significance in preoperative MVV,FVC and FEV1 between the two groups(P>0.05).Compared with before surgery,the levels of MVV,FVC and FEV1 in two groups were decreased 3 days after surgery,and the levels in observation group were(76.34±4.42),(77.79±5.24)and(80.23±7.7),respectively,which were higher than those in control group(P<0.05).All indexes of observation group were better than control group(P<0.05).The incidence of postoperative complications in the observation group was 11.63%,which was lower than that in the co

关 键 词：硬膜外阻滞麻醉 全身麻醉 老年结肠癌根治术 临床指标 肺功能 

分 类 号：R735[医药卫生—肿瘤]