腰-硬联合麻醉在子宫全切术中的应用观察
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摘要
目的分析腰硬联合麻醉在子宫全切术中的应用方法与效果。方法选择2016年1月至2018年5月在我院行子宫全切术的患者作为案例进行对比研究,将所选的案例以随机数字法的方式分组处理。常规组与实验组分别应用传统麻醉与改良麻醉方式。观察和对比两组患者麻醉有效性与安全性。结果两组患者去氧肾上腺素用量、输液量、最高平面所需时间数据差异不突出,组间对比结果无意义(P>0.05);实验组恶心呕吐、头晕的发生率相对于常规组而言数据优势突出,组间对比结果满足统计学意义标准(P<0.05);两组患者的麻醉效果均比较理想,麻醉之后5min常规组患者的生命体征有明显波动,SBP、DBP、HR数值波动较大,与实验组相比数据差异较大,组间对比结果满足统计学意义标准(P<0.05)。结论腰硬联合麻醉在子宫全切术中的应用显著,手术期间麻醉效果理想,并且对于血流动力学影响较小,更利于患者的后续康复,值得临床推广。
Objective To analyze the application and effect of combined spinal and epidural anesthesia in total hysterectomy. Methods Patients who underwent hysterectomy in our hospital from January 2016 to May 2018 were selected as a case study. The selected cases were grouped by random number method. Conventional anesthesia and modified anesthesia were applied to the conventional group and the experimental group respectively. Observe and compare the anesthesia effectiveness and safety of the two groups of patients. Results The difference in phenylephrine dosage, infusion volume, and time required for the highest plane was not prominent between the two groups. The comparison between groups was not significant(P>0.05). The incidence of nausea and vomiting and dizziness in the experimental group was relative to the conventional group. The data superiority was prominent, and the comparison between the groups met the statistical significance criteria(P<0.05). The anesthetic effects of the two groups were ideal. The vital signs of the routine group were significantly fluctuated 5 minutes after anesthesia, SBP, DBP, HR values. The fluctuation was larger, and the data were more different than the experimental group. The comparison between the groups met the statistical significance(P<0.05). Conclusion The combination of lumbar and spinal anesthesia is effective in the total hysterectomy. The anesthesia effect is ideal during the operation, and the hemodynamic effect is small, which is more conducive to the subsequent rehabilitation of the patient. It is worthy of clinical promotion.
Objective To analyze the application and effect of combined spinal and epidural anesthesia in total hysterectomy. Methods Patients who underwent hysterectomy in our hospital from January 2016 to May 2018 were selected as a case study. The selected cases were grouped by random number method. Conventional anesthesia and modified anesthesia were applied to the conventional group and the experimental group respectively. Observe and compare the anesthesia effectiveness and safety of the two groups of patients. Results The difference in phenylephrine dosage, infusion volume, and time required for the highest plane was not prominent between the two groups. The comparison between groups was not significant(P>0.05). The incidence of nausea and vomiting and dizziness in the experimental group was relative to the conventional group. The data superiority was prominent, and the comparison between the groups met the statistical significance criteria(P<0.05). The anesthetic effects of the two groups were ideal. The vital signs of the routine group were significantly fluctuated 5 minutes after anesthesia, SBP, DBP, HR values. The fluctuation was larger, and the data were more different than the experimental group. The comparison between the groups met the statistical significance(P<0.05). Conclusion The combination of lumbar and spinal anesthesia is effective in the total hysterectomy. The anesthesia effect is ideal during the operation, and the hemodynamic effect is small, which is more conducive to the subsequent rehabilitation of the patient. It is worthy of clinical promotion.
引文
[1]李慧静.腰硬联合麻醉与单纯硬膜外麻醉在阴式子宫全切术中的效果比较[J].中国社区医师,2012,34(19):2965-2966.
[2]范国义,韩志强.右美托咪定自控镇静在腰硬联合麻醉全子宫切除术中的应用[J].临床误诊误治,2016,29(12):67-70.
[3]范国义,韩志强.罗哌卡因对腰硬联合麻醉下子宫全切术患者运动神经阻滞的影响[J].检验医学与临床,2016,13(15):2095-2096.
[4]佘志华,吴蔚.尿药法研究头孢硫脒在腰-硬联合麻醉状态下行子宫全切术患者体内药代动力学[J].医学临床研究,2017,34(4):631-634.
[5]丁荷蓓,张稳稳,陈为国,等.右美托咪定对腰硬联合麻醉下子宫肌瘤切除术患者术中的镇静效果及综合评价[J].现代生物医学进展,2017,23(29):5736-5739.
[6]李晓声.经皮穴位电刺激复合腰硬联合麻醉在下肢骨科手术中镇静镇痛应用观察[J].辽宁中医药大学学报,2016,13(2):193-195.
[7]周海东.帕瑞昔布钠联合超声引导腹横肌平面阻滞对妇科腹腔镜手术后镇痛效果的影响[J].中国医师进修杂志,2016,39(11):1008-1011.
[8]董金春,王胜斌,徐四七,等.右美托咪定联合利多卡因静脉输注对全麻下子宫切除患者炎性因子的影响[J].实用医学杂志,2018,13(5):233-234.
[9]周麦玲,雷燕.早期宫颈癌患者行子宫广泛切除联合阴道延长术后心理状况及性生活状态的评估[J].中国性科学,2018,21(2):52-54.
[10]吕虎,陈万坤,赵燕君.地佐辛或氟比洛芬酯复合丙泊酚-瑞芬太尼静脉麻醉在子宫颈癌前病变锥切术中麻醉效果的比较[J].中国癌症杂志,2018,28(2):146-150.
[2]范国义,韩志强.右美托咪定自控镇静在腰硬联合麻醉全子宫切除术中的应用[J].临床误诊误治,2016,29(12):67-70.
[3]范国义,韩志强.罗哌卡因对腰硬联合麻醉下子宫全切术患者运动神经阻滞的影响[J].检验医学与临床,2016,13(15):2095-2096.
[4]佘志华,吴蔚.尿药法研究头孢硫脒在腰-硬联合麻醉状态下行子宫全切术患者体内药代动力学[J].医学临床研究,2017,34(4):631-634.
[5]丁荷蓓,张稳稳,陈为国,等.右美托咪定对腰硬联合麻醉下子宫肌瘤切除术患者术中的镇静效果及综合评价[J].现代生物医学进展,2017,23(29):5736-5739.
[6]李晓声.经皮穴位电刺激复合腰硬联合麻醉在下肢骨科手术中镇静镇痛应用观察[J].辽宁中医药大学学报,2016,13(2):193-195.
[7]周海东.帕瑞昔布钠联合超声引导腹横肌平面阻滞对妇科腹腔镜手术后镇痛效果的影响[J].中国医师进修杂志,2016,39(11):1008-1011.
[8]董金春,王胜斌,徐四七,等.右美托咪定联合利多卡因静脉输注对全麻下子宫切除患者炎性因子的影响[J].实用医学杂志,2018,13(5):233-234.
[9]周麦玲,雷燕.早期宫颈癌患者行子宫广泛切除联合阴道延长术后心理状况及性生活状态的评估[J].中国性科学,2018,21(2):52-54.
[10]吕虎,陈万坤,赵燕君.地佐辛或氟比洛芬酯复合丙泊酚-瑞芬太尼静脉麻醉在子宫颈癌前病变锥切术中麻醉效果的比较[J].中国癌症杂志,2018,28(2):146-150.