中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2014年
4期
276-279
,共4页
王铁皓%赵纪春%黄斌%马玉奎%袁丁%杨轶%曾国军%熊飞%吴洲鹏
王鐵皓%趙紀春%黃斌%馬玉奎%袁丁%楊軼%曾國軍%熊飛%吳洲鵬
왕철호%조기춘%황빈%마옥규%원정%양질%증국군%웅비%오주붕
主动脉瘤,腹%麻醉%腔内修复术
主動脈瘤,腹%痳醉%腔內脩複術
주동맥류,복%마취%강내수복술
Aortic aneurysm,abdominal%Anesthesia%Endovascular aneurysm repair (EVAR)
目的 总结在不同麻醉方式下行腹主动脉瘤腔内治疗(endovascular aneurysm repair,EVAR)的围手术期结果,为EVAR术选择麻醉方式提供参考.方法 回顾性分析四川大学华西医院血管外科从2006年1月至2012年9月收治的择期接受EVAR术的276例腹主动脉瘤(abdominal aortic aneurysm,AAA)患者的临床资料,其中105例(38.0％)采用局部麻醉(local anesthesia,LA),56例(20.3％)采用硬膜外麻醉(epidural anesthesia,EDA),115例(41.7％)采用全身麻醉(generalanesthesia,GA),比较3组基线资料、动脉瘤数据资料、围术期相关资料.结果 术中麻醉或手术方式无改变.LA组的肺部疾病患病率(71/105,67.6％)显著高于GA组(60/115,52.2％,P=0.020).LA组较EDA及GA组显著缩短了手术持续时间、ICU观察时间、术后禁食时间及术后住院时间,其差异具有统计学意义.LA组术后肺部并发症发生率(1/105,1％)显著低于GA组(11/115,9.6％,P=0.005).麻醉方式是术后并发症发生的独立危险因素,局部麻醉显著降低了术后发生并发症的风险.结论 局部麻醉更有利于EVAR术后患者的恢复,局部麻醉可能成为EVAR优先选择的麻醉方式.
目的 總結在不同痳醉方式下行腹主動脈瘤腔內治療(endovascular aneurysm repair,EVAR)的圍手術期結果,為EVAR術選擇痳醉方式提供參攷.方法 迴顧性分析四川大學華西醫院血管外科從2006年1月至2012年9月收治的擇期接受EVAR術的276例腹主動脈瘤(abdominal aortic aneurysm,AAA)患者的臨床資料,其中105例(38.0％)採用跼部痳醉(local anesthesia,LA),56例(20.3％)採用硬膜外痳醉(epidural anesthesia,EDA),115例(41.7％)採用全身痳醉(generalanesthesia,GA),比較3組基線資料、動脈瘤數據資料、圍術期相關資料.結果 術中痳醉或手術方式無改變.LA組的肺部疾病患病率(71/105,67.6％)顯著高于GA組(60/115,52.2％,P=0.020).LA組較EDA及GA組顯著縮短瞭手術持續時間、ICU觀察時間、術後禁食時間及術後住院時間,其差異具有統計學意義.LA組術後肺部併髮癥髮生率(1/105,1％)顯著低于GA組(11/115,9.6％,P=0.005).痳醉方式是術後併髮癥髮生的獨立危險因素,跼部痳醉顯著降低瞭術後髮生併髮癥的風險.結論 跼部痳醉更有利于EVAR術後患者的恢複,跼部痳醉可能成為EVAR優先選擇的痳醉方式.
목적 총결재불동마취방식하행복주동맥류강내치료(endovascular aneurysm repair,EVAR)적위수술기결과,위EVAR술선택마취방식제공삼고.방법 회고성분석사천대학화서의원혈관외과종2006년1월지2012년9월수치적택기접수EVAR술적276례복주동맥류(abdominal aortic aneurysm,AAA)환자적림상자료,기중105례(38.0％)채용국부마취(local anesthesia,LA),56례(20.3％)채용경막외마취(epidural anesthesia,EDA),115례(41.7％)채용전신마취(generalanesthesia,GA),비교3조기선자료、동맥류수거자료、위술기상관자료.결과 술중마취혹수술방식무개변.LA조적폐부질병환병솔(71/105,67.6％)현저고우GA조(60/115,52.2％,P=0.020).LA조교EDA급GA조현저축단료수술지속시간、ICU관찰시간、술후금식시간급술후주원시간,기차이구유통계학의의.LA조술후폐부병발증발생솔(1/105,1％)현저저우GA조(11/115,9.6％,P=0.005).마취방식시술후병발증발생적독립위험인소,국부마취현저강저료술후발생병발증적풍험.결론 국부마취경유리우EVAR술후환자적회복,국부마취가능성위EVAR우선선택적마취방식.
Objective To compare perioperative outcomes of endovascular abdominal aortic aneurysm repair (EVAR) by different methods of anesthesia.Method From January 2006 to September 2012,276 abdominal aortic aneurysm (AAA) patients undergoing EVAR in West China Hospital were retrospectively analyzed.Among these patients,105 cases (38.0％) received LA,56 patients (20.3％) received EDA,115 patients (41.7％) received GA.Data of perioperative outcome and AAA among three different anesthesia groups were collected.Result Conversion of anesthetic techniques was not required.Lung complication was significantly lower in the GA group (60/115,52.2％) than the LA group (71/105,67.6％,P =0.02).Compared with EDA and GA groups,patients in LA group had significantly shorter operating time,time of ICU stay,time to ambulation and hospital stay.Logistic regression analysis indicated the anesthesia method was an independent related factor for postoperative complications and LA decreased morbidity of patients with EVAR.Conclusions Local anesthesia has the advantages of shorter operation time and lower incidence of complications.
