CAJ | 학술논문

目的：探讨光纤硬膜外导管下硬膜外腔的解剖生理学特点，分析光纤硬膜外导管下置管较盲探下置管的技术优势。方法选择研究我院2013年1月至11月收治的60例需要进行硬膜外麻醉腹部手术患者资料，麻醉时分别采用普通导管(30例)与光纤硬膜外导管(30例)，观察患者的麻醉和硬膜外腔的解剖结构特点。结果患者在插管后5 min、切皮时的HR、SPB和MAP与同组麻醉前、诱导前、插管前及观察组比较，差异具有统计学意义(P<0.05)。硬膜外腔与椎管骨膜之间形成1个腔隙，这个腔隙并不与颅腔联通，但是含有一定的结缔组织和静脉丛，腔体容积一般能够达到100 mL左右，其前部与侧方不宽，而后部宽度较大，从颈部开始逐步扩大到腰部之后达到顶峰，而后逐步缩窄，一直到骶裂孔。结论光纤硬膜外导管可使患者的解剖生理结构更加清晰呈现，使麻醉医生从盲目置管达到明视置管。
목적：탐토광섬경막외도관하경막외강적해부생이학특점，분석광섬경막외도관하치관교맹탐하치관적기술우세。방법선택연구아원2013년1월지11월수치적60례수요진행경막외마취복부수술환자자료，마취시분별채용보통도관(30례)여광섬경막외도관(30례)，관찰환자적마취화경막외강적해부결구특점。결과환자재삽관후5 min、절피시적HR、SPB화MAP여동조마취전、유도전、삽관전급관찰조비교，차이구유통계학의의(P<0.05)。경막외강여추관골막지간형성1개강극，저개강극병불여로강련통，단시함유일정적결체조직화정맥총，강체용적일반능구체도100 mL좌우，기전부여측방불관，이후부관도교대，종경부개시축보확대도요부지후체도정봉，이후축보축착，일직도저렬공。결론광섬경막외도관가사환자적해부생리결구경가청석정현，사마취의생종맹목치관체도명시치관。
Objective To discuss the epidural cavity surgical anatomical physiology under fiber optic epidural catheter, and to analyze the technological advantages compared to the the agent under blind. Methods 60 cases who need to epidural abdominal surgery from Jan. to Nov. 2013 were collected. Common duct (30 cases) and fiber optical epidural catheter (30 cases) were respectively used at anesthesia, and the epidural cavity surgical anatomy physiology were observed. Results Compared with indexs before anesthesia, before induction and before intubation, the HR, SPB, and MAP in 5 min after intubation and at the moment of skin incision were of statistically significant differ-ences (P<0. 05). There is a cavity between epidural space and vertebral canal periosteum which is not linked to cranial cavity, but there were a certain amount of connective tissue and venous plexus. The volume of the cavity was about 100 mL, the front and side were narrow and the back was wide, and it began to gradually expand from the neck, and reached its peak at the waist, and then gradually narrowed, un-til the sacral hiatus. Conclusion Fiber optic epidural catheter could make the patient’ s anatomy physiology structure more clear, and it also make it possible to cathetering visually for the anesthesiologist.