中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2011年
20期
34-36
,共3页
气腹%麻醉%腹腔镜子宫切除术%重度贫血
氣腹%痳醉%腹腔鏡子宮切除術%重度貧血
기복%마취%복강경자궁절제술%중도빈혈
Pneumoperitoneum%Anesthesia%Laparoscopic hysterectomy%Severe anemia
目的 探讨硬膜外复合全身麻醉在重度贫血患者腹腔镜子宫全切除术中气腹对呼吸和循环的影响.方法 选择60例重度贫血患者拟行腹腔镜子宫切除术,随机分为单纯全麻组(G组)30例和硬膜外复合全麻组(EG组)30例.于麻醉前10 min(T0)、CO2气腹后10 min(T1)、CO2气后30 min(T2)及术毕10 min( T3)时测量平均动脉压(MAP)、心率(HR)、脉搏氧分压(SpO2)、呼气末二氧化碳分压(PETCO2)、气道压(Paw)的变化及术后苏醒质量的评估.结果 G组T1、T2、T3时MAP、HR显著高于T0 (P＜0.05); EG组各时点MAP、HR比较差异无统计学意义；两组间相比,G组T1时MAP、HR显著高于EG组同时间点；两组T2、T3的PETCO2显著高于T0值(P＜0.05)；气腹后两组Paw明显上升,与气腹前相比差异有统计学意义(P＜0.05).EG组术毕即能清醒拔管,完全清醒时间、拔管时间明显短于G组(P＜0.01),EG组术后清醒质量明显优于G组(P＜0.05).结论 全身麻醉复合硬膜外组能更有效地抑制CO2气腹和手术刺激等所致的不良反应,可减少全麻药的用量,术毕患者苏醒快,清醒质量优,可缩短拔管时间.
目的 探討硬膜外複閤全身痳醉在重度貧血患者腹腔鏡子宮全切除術中氣腹對呼吸和循環的影響.方法 選擇60例重度貧血患者擬行腹腔鏡子宮切除術,隨機分為單純全痳組(G組)30例和硬膜外複閤全痳組(EG組)30例.于痳醉前10 min(T0)、CO2氣腹後10 min(T1)、CO2氣後30 min(T2)及術畢10 min( T3)時測量平均動脈壓(MAP)、心率(HR)、脈搏氧分壓(SpO2)、呼氣末二氧化碳分壓(PETCO2)、氣道壓(Paw)的變化及術後囌醒質量的評估.結果 G組T1、T2、T3時MAP、HR顯著高于T0 (P＜0.05); EG組各時點MAP、HR比較差異無統計學意義；兩組間相比,G組T1時MAP、HR顯著高于EG組同時間點；兩組T2、T3的PETCO2顯著高于T0值(P＜0.05)；氣腹後兩組Paw明顯上升,與氣腹前相比差異有統計學意義(P＜0.05).EG組術畢即能清醒拔管,完全清醒時間、拔管時間明顯短于G組(P＜0.01),EG組術後清醒質量明顯優于G組(P＜0.05).結論 全身痳醉複閤硬膜外組能更有效地抑製CO2氣腹和手術刺激等所緻的不良反應,可減少全痳藥的用量,術畢患者囌醒快,清醒質量優,可縮短拔管時間.
목적 탐토경막외복합전신마취재중도빈혈환자복강경자궁전절제술중기복대호흡화순배적영향.방법 선택60례중도빈혈환자의행복강경자궁절제술,수궤분위단순전마조(G조)30례화경막외복합전마조(EG조)30례.우마취전10 min(T0)、CO2기복후10 min(T1)、CO2기후30 min(T2)급술필10 min( T3)시측량평균동맥압(MAP)、심솔(HR)、맥박양분압(SpO2)、호기말이양화탄분압(PETCO2)、기도압(Paw)적변화급술후소성질량적평고.결과 G조T1、T2、T3시MAP、HR현저고우T0 (P＜0.05); EG조각시점MAP、HR비교차이무통계학의의；량조간상비,G조T1시MAP、HR현저고우EG조동시간점；량조T2、T3적PETCO2현저고우T0치(P＜0.05)；기복후량조Paw명현상승,여기복전상비차이유통계학의의(P＜0.05).EG조술필즉능청성발관,완전청성시간、발관시간명현단우G조(P＜0.01),EG조술후청성질량명현우우G조(P＜0.05).결론 전신마취복합경막외조능경유효지억제CO2기복화수술자격등소치적불량반응,가감소전마약적용량,술필환자소성쾌,청성질량우,가축단발관시간.
Objective To discuss the effect of epidural anesthesia in patients with severe anemia in laparoscopic hysterectomy pneum0peritoneum on respiratory and circulatory effects.Methods We selected 60 patients with severe anemia were scheduled for laparoscopic hysterectomy and they were randomly divided into two groups,30 cases each group.General anesthesia group (group G),epidural anesthesia group (group EG).Before anesthesia 10 min (T0 ),CO2 pneumoperitoneum after 10 min (T1 ),CO2 gas after 30 min (T2 ),and of surgery 10 min (T3 ) measured at MAP,HR,SpO2,PETCO2,airway pressure (Paw) changes and the assessment of the quality of postoperative recovery.Results MAP,HR were significantly higher at T1,T2,T3 in group G than T0 ( P ＜ 0.05 ) ; MAP and HR were no significant difference at each time point in group EG; MAP and HR at T1 in group G were significantly higher than the same time point in group EG; T2,T3 ' s PETCO2 were significantly higher than the T0 value in both groups (P ＜ 0.05 ) ; The both groups after pneumoperitoneum airway pressure (Paw) increased significantly.Compared with before pneumoperitoneum,there were significant differences (P ＜ 0.05).Group EG of surgery that was able to awake extubation,fully awake time,extubation time were shorter than that in group G (P ＜ 0.01 ).The qulaity of clear in group EG was better than that in group G (P ＜ 0.05).Conclusions Anesthesia combined with epidural group could more effectively inhibit the CO2 pneumoperitoneum and surgical stimulation-induced adverse reactions,and can reduce the amount of anesthetics,rapid recovery of surgery patients,clear quality,shorten time to extubation.
