CAJ | 학술논문

　　目的探讨全身麻醉（全麻）联合硬膜外麻醉在胸部手术中的应用。方法128例胸部手术的患者随机分为观察组（全麻联合硬膜外麻醉）和对照组（全麻），比较两组在术前30 min、术中10 min、术后10 min收缩压（SBP）、平均动脉压（MAP）、舒张压（DBP）、心率（HR）、脉搏血氧饱和度（SpO 2）等各指标监测，两组患者不良反应、拔管时间、术后自主呼吸恢复时间，完全清醒时间以及镇痛效果比较。结果两组患者在术中及术后SBP、MAP、DBP、HR比较差异有统计学意义（P<0.05）。两组患者在麻醉过程中给予面罩吸氧，SpO 2比较差异无统计学意义；观察组在术前、术中、术后各指标都比较稳定，生命体征平稳。观察组患者在术后不良反应少，拔管时间、术后自主呼吸恢复时间和完全清醒时间明显短于对照组；观察组镇痛效果总有效率（100%）显著高于对照组（90.62%）（P<0.05）。结论全麻联合硬膜外麻醉在胸部手术中能保持循环、呼吸功能的稳定，在降低患者的应激反应中有显著效果，降低全麻的不良反应，对心血管系统具有一定的保护作用。
　　목적탐토전신마취（전마）연합경막외마취재흉부수술중적응용。방법128례흉부수술적환자수궤분위관찰조（전마연합경막외마취）화대조조（전마），비교량조재술전30 min、술중10 min、술후10 min수축압（SBP）、평균동맥압（MAP）、서장압（DBP）、심솔（HR）、맥박혈양포화도（SpO 2）등각지표감측，량조환자불량반응、발관시간、술후자주호흡회복시간，완전청성시간이급진통효과비교。결과량조환자재술중급술후SBP、MAP、DBP、HR비교차이유통계학의의（P<0.05）。량조환자재마취과정중급여면조흡양，SpO 2비교차이무통계학의의；관찰조재술전、술중、술후각지표도비교은정，생명체정평은。관찰조환자재술후불량반응소，발관시간、술후자주호흡회복시간화완전청성시간명현단우대조조；관찰조진통효과총유효솔（100%）현저고우대조조（90.62%）（P<0.05）。결론전마연합경막외마취재흉부수술중능보지순배、호흡공능적은정，재강저환자적응격반응중유현저효과，강저전마적불량반응，대심혈관계통구유일정적보호작용。
Objective To investigate clinical application of general anesthesia combined with epidural anesthesia in the thoracic surgery. Methods 128 cases of thoracic surgery patients were randomLy divided into observation group (general anesthesia combined with epidural anesthesia) and control group (general anesthesia).The systolic blood pressure (SBP), mean arterial pressure (MAP), diastolic blood pressure (DBP), heart rate (HR), oxygen saturation (SpO 2) and adverse reactions, extubation time, postoperative recovery of spontaneous breathing time , fully awake and analgesia of two groups were analysed. Results The SBP , MAP, DBP, and HR of two groups in the intraoperative and postoperative have a significant difference (P<0.05). The two groups of patients during anesthesia given oxygen mask, SpO 2 was no significant difference;observation group in the preoperative , intraoperative , postoperative indicators are relatively stable, with stable vital signs . The adverse postoperative extubation time , postoperative recovery of spontaneous breathing and fully awake time of the observation group was significantly shorter than the control group;The total effective rate of analgesic effect of the observation group(100%) was significantly higher analgesic the control group (90.62%) (P<0.05). Conclusion The general anesthesia combined with epidural anesthesia in thoracic surgery can maintain the stability of the circulatory, respiratory function , have a significant effect in the stress response in patients with low to reduce adverse anesthesia , has a protective effect on the cardiovascular system.