中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2013年
19期
2905-2907
,共3页
余世华%曾秀英%李鄂安%王合意
餘世華%曾秀英%李鄂安%王閤意
여세화%증수영%리악안%왕합의
麻醉,全身%麻醉,硬膜外%肺疾病,慢性阻塞性
痳醉,全身%痳醉,硬膜外%肺疾病,慢性阻塞性
마취,전신%마취,경막외%폐질병,만성조새성
Anesthesia,general%Anesthesia,epidural%Pulmonary disease,chronic obstructive
目的 观察全身麻醉复合硬膜外腔阻滞麻醉用于慢性阻塞性肺疾病(COPD)患者手术的临床效果.方法 选取262例合并COPD需行胸腹部外科和泌尿外科等手术的患者,按时间顺序将患者分为对照组和观察组各131例,分别行单纯全身麻醉和全身麻醉复合硬膜外腔阻滞麻醉,对比观察两组患者手术时间、术后拔管时间、苏醒时间和镇痛效果(VAS评分)等麻醉情况,测定患者用力肺活量(FVC)、第一秒最大呼气率(FEV1/FVC)和用力呼气中段流速(FEF25％～27％)等肺功能指标,对两种麻醉方法的临床效果及并发症发生率进行研究.结果 观察组患者拔管时间、苏醒时间及VAS评分均明显低于对照组(均P＜0.05).术后观察组患者用力肺活量(FVC)、第一秒最大呼气率(FEV1/FVC)和用力呼气中段流速(FEF25％～27％)等肺功能指标检测结果明显优于对照组患者(均P ＜0.05).对照组患者麻醉的总有效率为87.0％,观察组患者麻醉的总有效率为96.9％,观察组麻醉的临床效果优于对照组(P＜0.05).两组患者的手术时间和术后并发症发生率差异无统计学意义(P＞0.05).结论 全身麻复合硬膜外腔阻滞麻醉应用于COPD患者手术可有效提高麻醉的临床效果,加强了麻醉的安全性,利于患者术后的康复,值得在临床上推广.
目的 觀察全身痳醉複閤硬膜外腔阻滯痳醉用于慢性阻塞性肺疾病(COPD)患者手術的臨床效果.方法 選取262例閤併COPD需行胸腹部外科和泌尿外科等手術的患者,按時間順序將患者分為對照組和觀察組各131例,分彆行單純全身痳醉和全身痳醉複閤硬膜外腔阻滯痳醉,對比觀察兩組患者手術時間、術後拔管時間、囌醒時間和鎮痛效果(VAS評分)等痳醉情況,測定患者用力肺活量(FVC)、第一秒最大呼氣率(FEV1/FVC)和用力呼氣中段流速(FEF25％～27％)等肺功能指標,對兩種痳醉方法的臨床效果及併髮癥髮生率進行研究.結果 觀察組患者拔管時間、囌醒時間及VAS評分均明顯低于對照組(均P＜0.05).術後觀察組患者用力肺活量(FVC)、第一秒最大呼氣率(FEV1/FVC)和用力呼氣中段流速(FEF25％～27％)等肺功能指標檢測結果明顯優于對照組患者(均P ＜0.05).對照組患者痳醉的總有效率為87.0％,觀察組患者痳醉的總有效率為96.9％,觀察組痳醉的臨床效果優于對照組(P＜0.05).兩組患者的手術時間和術後併髮癥髮生率差異無統計學意義(P＞0.05).結論 全身痳複閤硬膜外腔阻滯痳醉應用于COPD患者手術可有效提高痳醉的臨床效果,加彊瞭痳醉的安全性,利于患者術後的康複,值得在臨床上推廣.
목적 관찰전신마취복합경막외강조체마취용우만성조새성폐질병(COPD)환자수술적림상효과.방법 선취262례합병COPD수행흉복부외과화비뇨외과등수술적환자,안시간순서장환자분위대조조화관찰조각131례,분별행단순전신마취화전신마취복합경막외강조체마취,대비관찰량조환자수술시간、술후발관시간、소성시간화진통효과(VAS평분)등마취정황,측정환자용력폐활량(FVC)、제일초최대호기솔(FEV1/FVC)화용력호기중단류속(FEF25％～27％)등폐공능지표,대량충마취방법적림상효과급병발증발생솔진행연구.결과 관찰조환자발관시간、소성시간급VAS평분균명현저우대조조(균P＜0.05).술후관찰조환자용력폐활량(FVC)、제일초최대호기솔(FEV1/FVC)화용력호기중단류속(FEF25％～27％)등폐공능지표검측결과명현우우대조조환자(균P ＜0.05).대조조환자마취적총유효솔위87.0％,관찰조환자마취적총유효솔위96.9％,관찰조마취적림상효과우우대조조(P＜0.05).량조환자적수술시간화술후병발증발생솔차이무통계학의의(P＞0.05).결론 전신마복합경막외강조체마취응용우COPD환자수술가유효제고마취적림상효과,가강료마취적안전성,리우환자술후적강복,치득재림상상추엄.
Objective To observation the clinical effect of anesthesia combined with epidural block for patients with COPD surgery.Methods 262 cases with COPD needed to line the chest and abdominal surgery and urology surgery patients.Patients were divided into control group and observation group according to the time sequence,underwent general anesthesia and anesthesia combined with epidural anesthesia,contrast observed in patients with operative time,postoperative extubation time,wake time and the analgesic effect of anesthesia (VAS score) was measured in patients with FVC,FEV1/FVC and FEF25％ to 27％ lung function,clinical efficacy and complication rate of two anesthesia methods.Results The patients extubation time,recovery time and VAS scores were significantly lower than those of control group,the differences were statistically significant(all P ＜0.05).Group of postoperative patients with FVC,FEV1/FVC and FEF25％ to 27％,such as lung function test results were significantly better than those of control group,and the difference was statistically significant (all P ＜0.05).Anesthesia control group total effective rate of 87.0％ observed in patients anesthesia total effective rate was 96.9％.Compared with the control group,the anesthesia clinical effect of the observation group was statistically significant (P ＜0.05).Operative time and postoperative complication rate of the two groups of patients showed no significant difference(P ＞0.05).Conclusion Anesthesia combined with epidural anesthesia used in surgery in patients with COPD can effectively improve the clinical effects of anesthesia,to enhance the safety of anesthesia,which will help the rehabilitation of patients and worth of clinical practice.
