实用医院临床杂志
實用醫院臨床雜誌
실용의원림상잡지
PRACTICAL JOURNAL OF CLINICAL MEDICINE
2014年
5期
99-100,101
,共3页
硬膜外麻醉%下腹部手术
硬膜外痳醉%下腹部手術
경막외마취%하복부수술
Epidural anesthesia%Lower abdominal surgery
目的：探讨硬膜外腔选择性偏侧法置管在单侧下腹部手术麻醉中的临床应用。方法120例患者按随机数字表法分为I组II组。两组患者均取患侧卧位行直入法硬膜外腔穿刺，穿刺针到达硬膜外腔后，I组按常规头向置入硬膜外导管3～3.5 cm，II组将穿刺针口斜面向术侧旋转25～30°，向头侧置入导管3～3.5 cm。比较两组患者麻醉后不同时点血液动力学变化、麻醉平面不对称例数、麻醉效果、需要辅助用药的例数以及术后头痛、腰背痛情况。结果两组患者相同时点血液动力学变化差异无统计学意义（ P＞0.05）；II组的术侧感觉阻滞平面高的例数显著多于I组（ P＜0.05）；Ⅱ组麻醉效果（镇痛和肌松满意情况）显著优于Ⅰ组，差异有统计学意义（ P＜0.05）。结论硬膜外腔偏侧法置管用于单侧下腹部手术麻醉效果优于常规法置管。
目的：探討硬膜外腔選擇性偏側法置管在單側下腹部手術痳醉中的臨床應用。方法120例患者按隨機數字錶法分為I組II組。兩組患者均取患側臥位行直入法硬膜外腔穿刺，穿刺針到達硬膜外腔後，I組按常規頭嚮置入硬膜外導管3～3.5 cm，II組將穿刺針口斜麵嚮術側鏇轉25～30°，嚮頭側置入導管3～3.5 cm。比較兩組患者痳醉後不同時點血液動力學變化、痳醉平麵不對稱例數、痳醉效果、需要輔助用藥的例數以及術後頭痛、腰揹痛情況。結果兩組患者相同時點血液動力學變化差異無統計學意義（ P＞0.05）；II組的術側感覺阻滯平麵高的例數顯著多于I組（ P＜0.05）；Ⅱ組痳醉效果（鎮痛和肌鬆滿意情況）顯著優于Ⅰ組，差異有統計學意義（ P＜0.05）。結論硬膜外腔偏側法置管用于單側下腹部手術痳醉效果優于常規法置管。
목적：탐토경막외강선택성편측법치관재단측하복부수술마취중적림상응용。방법120례환자안수궤수자표법분위I조II조。량조환자균취환측와위행직입법경막외강천자，천자침도체경막외강후，I조안상규두향치입경막외도관3～3.5 cm，II조장천자침구사면향술측선전25～30°，향두측치입도관3～3.5 cm。비교량조환자마취후불동시점혈액동역학변화、마취평면불대칭례수、마취효과、수요보조용약적례수이급술후두통、요배통정황。결과량조환자상동시점혈액동역학변화차이무통계학의의（ P＞0.05）；II조적술측감각조체평면고적례수현저다우I조（ P＜0.05）；Ⅱ조마취효과（진통화기송만의정황）현저우우Ⅰ조，차이유통계학의의（ P＜0.05）。결론경막외강편측법치관용우단측하복부수술마취효과우우상규법치관。
Objective To observe the clinical effects of epidural anesthesia with selective place of epidural -tube in lower ab-dominal surgery .Methods One hundred twenty patients were randomly divided into I and II groups ,60 in each group .All patients in the two groups took the side decubitus for the epidural puncture .After the needle into the epidural cavity ,an epidural catheter was in-serted in the head direction in the group I ,while the epidural catheter was inserted to the operation side for 25~30 degrees in the group II.The depth of catheters from skin to the epidural cavity was 3 to 3.5 cm.Hemodynamic changes ,number of asymmetrical spinal anes-thesia,anesthesia effect ,number of patients require secondary treatment ,and postoperative headache and back pain were compared be -tween the two groups .Results At different time points ,there was no difference in hemodynamic parameters between the two groups . There were more cases in the group II having higher sensory block level on the operation side than that in the group I ( P<0.05 ) .An-esthesia effect ( satisfaction of analgesia and muscle relaxation ) in the group II was significantly better than that in the group I ( P <0.05 ) .Conclusion In lower abdominal surgery , epidural anesthesia with epidural-tube lateral placing method has better clinical effects than head direction placing method .
