CAJ | 학술논문

目的：比较全麻联合硬膜外麻醉与全身麻醉对腹部手术患者的胃肠道保护作用。方法将接受腹部手术的患者52例随机分为观察组和对照组，观察组患者接受全麻联合硬膜外麻醉，对照组患者接受全身麻醉。两组患者分别于麻醉前、麻醉后30 min、手术结束时和术后4 h检测两组患者胃黏膜pH值、血清肠脂肪酸结合蛋白（I-FABP）水平，比较两者患者术后胃肠道恢复情况。结果观察组在麻醉后30 min、手术结束时和术后4 h时胃黏膜pH值高于对照组，血清I-FABP水平明显低于对照组，差异均有统计学意义（t分别=4.15、5.66、3.92、14.68、12.74、8.64，P均＜0.05）；观察组患者术后腹胀评分明显低于对照组，肠鸣音出现时间和肛门排气时间均较对照组明显缩短，差异均有统计学意义（t分别=4.00、4.14、4.14，P均＜0.05）。结论全麻联合硬膜外麻醉对腹部手术患者的胃肠道保护作用明显。
목적：비교전마연합경막외마취여전신마취대복부수술환자적위장도보호작용。방법장접수복부수술적환자52례수궤분위관찰조화대조조，관찰조환자접수전마연합경막외마취，대조조환자접수전신마취。량조환자분별우마취전、마취후30 min、수술결속시화술후4 h검측량조환자위점막pH치、혈청장지방산결합단백（I-FABP）수평，비교량자환자술후위장도회복정황。결과관찰조재마취후30 min、수술결속시화술후4 h시위점막pH치고우대조조，혈청I-FABP수평명현저우대조조，차이균유통계학의의（t분별=4.15、5.66、3.92、14.68、12.74、8.64，P균＜0.05）；관찰조환자술후복창평분명현저우대조조，장명음출현시간화항문배기시간균교대조조명현축단，차이균유통계학의의（t분별=4.00、4.14、4.14，P균＜0.05）。결론전마연합경막외마취대복부수술환자적위장도보호작용명현。
Objective To compare the protective effect of general anesthesia combined with epidural anesthesia and sin-gle general anesthesia on the gastrointestinal tracts in patients with abdomen operation. Methods A total of 52 patients who received abdomen operation were randomly divided into observation group and control group. Cases in observation group received general anesthesia combined with epidural anesthesia, and cases in control group received single general anesthesia. The pH value of gastric mucous membrane, intestinal fatty acid binding protein (I-FABP) level in serum were detected respectively before anesthesia, at 30 minutes after anesthesia at end of the operation and at 4 hours after the op-eration. Results The pH value of gastric mucous membrane of observation group were significantly higher than that of the control group while I-FABP level of observation group were significantly lower than that of the control group with statistic difference (t=4.15, 5.66, 3.92, 14.68, 12.74, 8.64,P<0.05). The score of abdomen repletion of observation group were significantly lower than that of control group while the time of bowel tone and the time of first anal exhaustion of observa-tion group were significantly higher than that of control group(t=4.00, 4.14, 4.14, P<0.05). Conclusion General anes-thesia combined with epidural anesthesia has remarkable protective effect on the gastrointestinal tract in patients with ab-domen operation.