全身麻醉复合硬膜外阻滞的麻醉方式在老年结直肠癌行腹腔镜手术患者中应用效果
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摘要
目的探讨全身麻醉复合硬膜外阻滞的麻醉方式在老年结直肠癌行腹腔镜手术患者中应用的效果。方法 88例老年结直肠癌患者行腹腔镜手术治疗。按照随机数字表法分组,对照组44例,行全身麻醉;观察组44例,行硬膜外阻滞麻醉复合全身麻醉。对比两组的麻醉效果。结果观察组患者镇痛肌松效果显著高于对照组(P <0. 05);两组患者麻醉前及术后放气后5 min,对比心率(HR)及平均动脉压(MAP)差异均无统计学意义(P> 0. 05),但气腹前10 min及气腹后10 min比较,组间差异均有统计学意义(P <0. 05);且观察组患者术后拔管时间及睁眼时间均明显短于对照组(P <0. 05)。结论采用全身麻醉复合硬膜外阻滞的麻醉方式对老年结直肠癌腹腔镜手术患者可显著提高麻醉效果。
Objective To investigate the effect of general anesthesia combined with epidural block anesthesia in elderly patients with colorectal cancer undergoing laparoscopic surgery. Methods 88 cases of elderly patients with colorectal cancer were selected and treated by laparoscopic surgery. The patients were divided into control group( 44 cases) and observation group( 44 cases). The anesthesia effects of the two groups were compared. Results The analgesic muscle relaxation effect of the observation group was significantly higher than that of the control group( P < 0. 05).There was no statistical difference in heart rate( HR) and mean arterial pressure( MAP) between the two groups of patients before and after venting for 5 min( P > 0. 05),but the difference between the groups was statistically significant( P < 0. 05) in extubation time and the blink time in the observation group. In the control group( P < 0. 05). Conclusion General anesthesia combined with epidural anesthesia for elderly patients with colorectal cancer undergoing laparoscopic surgery can significantly improve the anesthesia effect,reduce stress response,and can be popularized and applied.
Objective To investigate the effect of general anesthesia combined with epidural block anesthesia in elderly patients with colorectal cancer undergoing laparoscopic surgery. Methods 88 cases of elderly patients with colorectal cancer were selected and treated by laparoscopic surgery. The patients were divided into control group( 44 cases) and observation group( 44 cases). The anesthesia effects of the two groups were compared. Results The analgesic muscle relaxation effect of the observation group was significantly higher than that of the control group( P < 0. 05).There was no statistical difference in heart rate( HR) and mean arterial pressure( MAP) between the two groups of patients before and after venting for 5 min( P > 0. 05),but the difference between the groups was statistically significant( P < 0. 05) in extubation time and the blink time in the observation group. In the control group( P < 0. 05). Conclusion General anesthesia combined with epidural anesthesia for elderly patients with colorectal cancer undergoing laparoscopic surgery can significantly improve the anesthesia effect,reduce stress response,and can be popularized and applied.
引文
[1]董鹏,李玉华,郭盟迪,等.全身麻醉复合硬膜外麻醉对老年腹腔镜结肠癌根治术患者术中血流动力学的影响[J].临床和实验医学杂志,2013,12(21):1726-1729.
[2]王立中,刘雪梅.全身麻醉复合硬膜外麻醉对老年腹腔镜直肠癌手术患者应激反应的影响[J].结直肠肛门外科,2013,19(5):310-312.
[3]吴静波,蔡杰衡,吴志镇.全身麻醉复合硬膜外阻滞行腹腔镜胆囊切除术对老年患者应激反应的影响[J].临床医学工程,2013,20(10):1228-1230.
[4]陈宏福,张瑞东,高宝斌.全身麻醉复合硬膜外麻醉在妇科腹腔镜手术中的效果及对血流动力学的影响[J].浙江医学,2016,38(16):1351-1353.
[5]李铁军,蔡淑女,印春铭.全身麻醉复合硬膜外阻滞麻醉在老年结直肠癌患者腹腔镜手术中的应用评价[J].中国肿瘤临床与康复,2015,22(2):191-193.
[6]朱二霞.老年结直肠癌患者腹腔镜手术不同麻醉方式效果比较研究[J].检验医学与临床,2014,11(23):3342-3343.
[7]周强.全身麻醉复合硬膜外阻滞麻醉在腹腔镜手术治疗老年直肠癌中的应用价值分析[J/CD].临床医药文献电子杂志,2016,3(53):10538-10539. DOI:ISSN.2095-8242. 2016. 53. 10538. 02.
[8]温迎春,周康华,付朝文,等.老年结直肠癌患者腹腔镜手术不同麻醉方式的比较[J].深圳中西医结合杂志,2016,26(5):11-12.
[9]郝伟,范惟,铁木尔.全身麻醉复合硬膜外麻醉对直肠癌老年患者腹腔镜手术治疗的临床效果分析[J].中外医疗,2017,36(17):109-110.
[10]赵卫兵,陈菲,彭方亮,等.不同麻醉方式应用于腹腔镜手术治疗老年直肠癌患者的效果研究[J].重庆医学,2016,45(13):1847-1848.
[11]曹维福.硬膜外阻滞对老年全身麻醉下腹腔镜结肠癌根治术后认知功能的影响[J].中国继续医学教育,2015,7(27):86-87.
[12]沈学用,谢少杰,陈仁军.全身麻醉联合区域神经阻滞对结直肠癌腹腔镜手术患者应激反应及镇痛效果的影响[J].医学临床研究,2017,34(5):906-909.
[13]黄斌.老年患者全身麻醉下行腹腔镜胆囊切除的硬膜外阻滞研究[J].当代医学,2017,23(3):44-45.
[14]王声,李学山,陈申平,等.老年腹腔镜手术患者采用全身麻醉联合硬膜外阻滞麻醉对患者认知功能的影响[J].医学理论与实践,2017,30(5):686-687.
[15]马岁谋.全身麻醉复合硬膜外阻滞麻醉与单纯全身麻醉在腹腔镜手术中的应用[J].吉林医学,2015,36(13):2845-2846.
[16]蔡俊岭,莫惠飞,骆智宇.两种麻醉方式对老年患者腹腔镜手术的比较[J].现代诊断与治疗,2013,24(7):1481-1483.
[17]古永焕.全身麻醉复合硬膜外阻滞在老年人腹部手术中的应用[J].中国社区医师(医学专业),2013,15(5):113-114.
[18]冉德伟.不同麻醉方法对直肠癌患者腹腔镜术中、术后的影响[J].实用癌症杂志,2016,31(9):1518-1520.
[19]王斌,李军,后瑞淼,等.全身麻醉复合硬膜外麻醉对腹腔镜直肠癌根治术患者心输出量影响[J].浙江临床医学,2016,18(7):1224-1226.
[20]何林,蒋燕.腹腔镜直肠癌手术中全身麻醉复合硬膜外麻醉对患者的影响[J].腹腔镜外科杂志,2017,22(3):194-196.
[21]胡丰登,张婷.硬脊膜外腔阻滞复合全身麻醉对髋关节骨折术后认知功能的影响[J].中国临床保健杂志,2018,21(3):349-352.
[22]李洋,卫木根,陈玉华,等.不同麻醉方式对老年肺癌根治术患者术后认知功能的影响[J].中国临床保健杂志,2017,20(3):303-305.
[2]王立中,刘雪梅.全身麻醉复合硬膜外麻醉对老年腹腔镜直肠癌手术患者应激反应的影响[J].结直肠肛门外科,2013,19(5):310-312.
[3]吴静波,蔡杰衡,吴志镇.全身麻醉复合硬膜外阻滞行腹腔镜胆囊切除术对老年患者应激反应的影响[J].临床医学工程,2013,20(10):1228-1230.
[4]陈宏福,张瑞东,高宝斌.全身麻醉复合硬膜外麻醉在妇科腹腔镜手术中的效果及对血流动力学的影响[J].浙江医学,2016,38(16):1351-1353.
[5]李铁军,蔡淑女,印春铭.全身麻醉复合硬膜外阻滞麻醉在老年结直肠癌患者腹腔镜手术中的应用评价[J].中国肿瘤临床与康复,2015,22(2):191-193.
[6]朱二霞.老年结直肠癌患者腹腔镜手术不同麻醉方式效果比较研究[J].检验医学与临床,2014,11(23):3342-3343.
[7]周强.全身麻醉复合硬膜外阻滞麻醉在腹腔镜手术治疗老年直肠癌中的应用价值分析[J/CD].临床医药文献电子杂志,2016,3(53):10538-10539. DOI:ISSN.2095-8242. 2016. 53. 10538. 02.
[8]温迎春,周康华,付朝文,等.老年结直肠癌患者腹腔镜手术不同麻醉方式的比较[J].深圳中西医结合杂志,2016,26(5):11-12.
[9]郝伟,范惟,铁木尔.全身麻醉复合硬膜外麻醉对直肠癌老年患者腹腔镜手术治疗的临床效果分析[J].中外医疗,2017,36(17):109-110.
[10]赵卫兵,陈菲,彭方亮,等.不同麻醉方式应用于腹腔镜手术治疗老年直肠癌患者的效果研究[J].重庆医学,2016,45(13):1847-1848.
[11]曹维福.硬膜外阻滞对老年全身麻醉下腹腔镜结肠癌根治术后认知功能的影响[J].中国继续医学教育,2015,7(27):86-87.
[12]沈学用,谢少杰,陈仁军.全身麻醉联合区域神经阻滞对结直肠癌腹腔镜手术患者应激反应及镇痛效果的影响[J].医学临床研究,2017,34(5):906-909.
[13]黄斌.老年患者全身麻醉下行腹腔镜胆囊切除的硬膜外阻滞研究[J].当代医学,2017,23(3):44-45.
[14]王声,李学山,陈申平,等.老年腹腔镜手术患者采用全身麻醉联合硬膜外阻滞麻醉对患者认知功能的影响[J].医学理论与实践,2017,30(5):686-687.
[15]马岁谋.全身麻醉复合硬膜外阻滞麻醉与单纯全身麻醉在腹腔镜手术中的应用[J].吉林医学,2015,36(13):2845-2846.
[16]蔡俊岭,莫惠飞,骆智宇.两种麻醉方式对老年患者腹腔镜手术的比较[J].现代诊断与治疗,2013,24(7):1481-1483.
[17]古永焕.全身麻醉复合硬膜外阻滞在老年人腹部手术中的应用[J].中国社区医师(医学专业),2013,15(5):113-114.
[18]冉德伟.不同麻醉方法对直肠癌患者腹腔镜术中、术后的影响[J].实用癌症杂志,2016,31(9):1518-1520.
[19]王斌,李军,后瑞淼,等.全身麻醉复合硬膜外麻醉对腹腔镜直肠癌根治术患者心输出量影响[J].浙江临床医学,2016,18(7):1224-1226.
[20]何林,蒋燕.腹腔镜直肠癌手术中全身麻醉复合硬膜外麻醉对患者的影响[J].腹腔镜外科杂志,2017,22(3):194-196.
[21]胡丰登,张婷.硬脊膜外腔阻滞复合全身麻醉对髋关节骨折术后认知功能的影响[J].中国临床保健杂志,2018,21(3):349-352.
[22]李洋,卫木根,陈玉华,等.不同麻醉方式对老年肺癌根治术患者术后认知功能的影响[J].中国临床保健杂志,2017,20(3):303-305.