中国现代医生
中國現代醫生
중국현대의생
CHINA MODERN DOCTOR
2015年
15期
105-107
,共3页
孙青山%邵长西%张正琰%吴殿红%魏春丽
孫青山%邵長西%張正琰%吳殿紅%魏春麗
손청산%소장서%장정염%오전홍%위춘려
上腹部手术%肿瘤%血流动力学%全身麻醉%硬膜外阻滞
上腹部手術%腫瘤%血流動力學%全身痳醉%硬膜外阻滯
상복부수술%종류%혈류동역학%전신마취%경막외조체
Upper abdominal surgery%Thoracic tumor%Hemodynamics%General anesthesia%Epidural
目的：比较硬膜外联合全身麻醉与单纯全麻在上腹部及胸内肿瘤手术中的麻醉效果。方法选择2013年7月~2014年12月期间我院收治的ASAI~Ⅱ级择期手术的上腹部及胸内肿瘤患者80例，分为两组，各40例，A组实施硬膜外阻滞联合全身麻醉，B组采用全身麻醉。比较两组麻醉药物用量、麻醉恢复情况及不同时间血流动力学变化。结果 A组丙泊酚、芬太尼和顺阿曲库铵用量较B组明显减少，术毕自主呼吸恢复时间、拔管时间及完全清醒时间均较B组明显缩短，苏醒期疼痛躁动发生率较B组明显较低，两组比较差异有统计学意义（P<0.05）。 B组T2时HR明显较A组增快，T3和T4时HR、SBP、DBP均明显高于A组，两组差异有统计学意义（P<0.05）。结论与单纯全麻比较，联合麻醉术中血流动力学稳定，能有效抑制手术应激反应，术后苏醒及拔管时间均短于单纯全麻组，围术期应用更具有安全性和平稳性。
目的：比較硬膜外聯閤全身痳醉與單純全痳在上腹部及胸內腫瘤手術中的痳醉效果。方法選擇2013年7月~2014年12月期間我院收治的ASAI~Ⅱ級擇期手術的上腹部及胸內腫瘤患者80例，分為兩組，各40例，A組實施硬膜外阻滯聯閤全身痳醉，B組採用全身痳醉。比較兩組痳醉藥物用量、痳醉恢複情況及不同時間血流動力學變化。結果 A組丙泊酚、芬太尼和順阿麯庫銨用量較B組明顯減少，術畢自主呼吸恢複時間、拔管時間及完全清醒時間均較B組明顯縮短，囌醒期疼痛躁動髮生率較B組明顯較低，兩組比較差異有統計學意義（P<0.05）。 B組T2時HR明顯較A組增快，T3和T4時HR、SBP、DBP均明顯高于A組，兩組差異有統計學意義（P<0.05）。結論與單純全痳比較，聯閤痳醉術中血流動力學穩定，能有效抑製手術應激反應，術後囌醒及拔管時間均短于單純全痳組，圍術期應用更具有安全性和平穩性。
목적：비교경막외연합전신마취여단순전마재상복부급흉내종류수술중적마취효과。방법선택2013년7월~2014년12월기간아원수치적ASAI~Ⅱ급택기수술적상복부급흉내종류환자80례，분위량조，각40례，A조실시경막외조체연합전신마취，B조채용전신마취。비교량조마취약물용량、마취회복정황급불동시간혈류동역학변화。결과 A조병박분、분태니화순아곡고안용량교B조명현감소，술필자주호흡회복시간、발관시간급완전청성시간균교B조명현축단，소성기동통조동발생솔교B조명현교저，량조비교차이유통계학의의（P<0.05）。 B조T2시HR명현교A조증쾌，T3화T4시HR、SBP、DBP균명현고우A조，량조차이유통계학의의（P<0.05）。결론여단순전마비교，연합마취술중혈류동역학은정，능유효억제수술응격반응，술후소성급발관시간균단우단순전마조，위술기응용경구유안전성화평은성。
Objective To compare the effect of epidural anesthesia combined with general anesthesia and general anesthesia in upper abdominal and thoracic tumor surgery anesthesia. Methods A total of 80 cases of ASAⅠ-IIelective surgery with the abdomen and chest patients were selected from July 2013 to December 2014 in our hospital, and divided into two groups, each of 40 cases, group A was treated with epidural block joint general anesthesia, group B was treated with general anesthesia. The amount of the anesthesia drug, anesthesia recovery and hemodynamic changes at different times of two groups were compared. Results Propofol, fentanyl and cis-atracurium dosage of group A were significantly reduced than group B, spontaneous breathing surgery recovery time, extubation time and fully awake time were significantly shorter, the occurrence of emergence agitation pain was significantly lower, the differences were statistically significant(P<0.05). HR in group B on T2 was significantly faster than group A, HR, SBP, DBP on T3 and T4 were significantly higher than that in group A, the differences were statistically significant (P<0.05). Conclusion Compare with general anesthesia, anesthesia of intraoperative hemodynamic stability, can suppress the stress response to surgery, recovery after extubation time is shorter than the general anesthesia group, perioperative application is more security and stability.
