海南医学
海南醫學
해남의학
HAINAN MEDICAL JOURNAL
2014年
19期
2833-2835
,共3页
快通道麻醉%老年%结直肠肿瘤
快通道痳醉%老年%結直腸腫瘤
쾌통도마취%노년%결직장종류
Fast-track anesthesia%Elderly%Colorectal cancer
目的：探讨快通道麻醉用于老年结直肠肿瘤手术的临床效果。方法92例老年结直肠肿瘤患者随机分为观察组(n=46)与对照组(n=46)，两组患者均给予腹腔镜手术治疗，观察组给予快通道静脉麻醉，对照组给予常规吸入麻醉，比较两组患者Steward麻醉苏醒评分及神经内分泌指标变化。结果观察组术后Steward≥4分者显著多于对照组(P<0.01)，且术后拔管时间显著短于对照组(P<0.01)；两组患者术前麻醉诱导前血浆皮质醇以及血糖浓度比较均差异无统计学意义(P>0.05)，而麻醉开始后观察组患者在切皮后、手术结束时以及术后1 h血浆皮质醇及血糖均显著低于对照组(P<0.05或P<0.01)；观察组术后出现恶心、呕吐发生率显著低于对照组(P<0.01)。结论快通道麻醉能够使患者获得较快的术后苏醒，同时降低了麻醉及手术操作对患者神经内分泌系统功能的影响，减少了麻醉损伤，且术后恶心呕吐等不良反应发生率较低，值得推广应用。
目的：探討快通道痳醉用于老年結直腸腫瘤手術的臨床效果。方法92例老年結直腸腫瘤患者隨機分為觀察組(n=46)與對照組(n=46)，兩組患者均給予腹腔鏡手術治療，觀察組給予快通道靜脈痳醉，對照組給予常規吸入痳醉，比較兩組患者Steward痳醉囌醒評分及神經內分泌指標變化。結果觀察組術後Steward≥4分者顯著多于對照組(P<0.01)，且術後拔管時間顯著短于對照組(P<0.01)；兩組患者術前痳醉誘導前血漿皮質醇以及血糖濃度比較均差異無統計學意義(P>0.05)，而痳醉開始後觀察組患者在切皮後、手術結束時以及術後1 h血漿皮質醇及血糖均顯著低于對照組(P<0.05或P<0.01)；觀察組術後齣現噁心、嘔吐髮生率顯著低于對照組(P<0.01)。結論快通道痳醉能夠使患者穫得較快的術後囌醒，同時降低瞭痳醉及手術操作對患者神經內分泌繫統功能的影響，減少瞭痳醉損傷，且術後噁心嘔吐等不良反應髮生率較低，值得推廣應用。
목적：탐토쾌통도마취용우노년결직장종류수술적림상효과。방법92례노년결직장종류환자수궤분위관찰조(n=46)여대조조(n=46)，량조환자균급여복강경수술치료，관찰조급여쾌통도정맥마취，대조조급여상규흡입마취，비교량조환자Steward마취소성평분급신경내분비지표변화。결과관찰조술후Steward≥4분자현저다우대조조(P<0.01)，차술후발관시간현저단우대조조(P<0.01)；량조환자술전마취유도전혈장피질순이급혈당농도비교균차이무통계학의의(P>0.05)，이마취개시후관찰조환자재절피후、수술결속시이급술후1 h혈장피질순급혈당균현저저우대조조(P<0.05혹P<0.01)；관찰조술후출현악심、구토발생솔현저저우대조조(P<0.01)。결론쾌통도마취능구사환자획득교쾌적술후소성，동시강저료마취급수술조작대환자신경내분비계통공능적영향，감소료마취손상，차술후악심구토등불량반응발생솔교저，치득추엄응용。
Objective To discuss the clinical effects of fast-track anesthesia in the surgery for colorectal can-cer in elderly patients. Methods Ninety-two elderly patients with colorectal cancer undergoing laparoscopic surgery were randomly divided into observation group (n=46) and control group (n=46). The observation group was given fast-track anesthesia, and the control group was given general inhalation anesthesia. And then the Steward scores and neuroendocrine changes were compared between the two groups. Results There were more patients with Steward≥4 after operation in the observation group than that in the control group (P<0.01), and the postoperative extubation time in the observation group was significantly shorter than that in the control group (P<0.01). There were no significantly differences in plasma cortisol and glucose concentrations between the two groups before induction of anesthesia (P>0.05). However, the plasma cortisol and glucose concentrations after the incision, in the end of surgery, and 1 h postoperative were significantly lower in the observation group than those in the control group (P<0.05 or P<0.01). Meanwhile, the inci-dence of nausea and vomiting postoperative in the observation group was significantly lower than that in the control group (P<0.01). Conclusion Fast-track anesthesia is worthy of promotion because of its faster postoperative recovery, less influ-ence of anesthesia and surgical operations on patients' neuroendocrine system function, less damage of anesthesia, and low-er incidence of adverse reactions such as postoperative nausea and vomiting.
