腰硬联合麻醉与全硬联合麻醉在腹腔镜子宫全切术中的应用效果对比(1)
[摘要] 目的 比较腰硬联合麻醉与全硬联合麻醉在腹腔镜子宫全切术中的应用效果。 方法 40例行腹腔镜子宫切除术患者，按随机数字表法分为腰硬麻醉组(对照组)、全硬麻醉组(观察组)，各20例，每组均于T0、T1、T2和T3，采集静脉血测定血糖(BG)、C反应蛋白(CRP)和白细胞介素-6(IL-6)浓度，并测量脉搏血氧饱和度(SpO2)和呼气末CO2分压(PETCO2)及血流动力学，如平均动脉压(MAP)、心率(HR)等的变化。观察术后两组并发症的发生率。 结果 两组SpO2和PETCO2在T1、T2、T3时间点分别与T0相比，差异均有统计学意义(P<0.05)；观察组T1时SpO2高于对照组，T1、T2时PETCO2明显低于对照组，差异有统计学意义(P<0.05)。与T0比较，对照组T1的MAP、HR明显升高，差异有统计学意义(P<0.05)；观察组各时间点的MAP、HR比较差异无统计学意义(P>0.05)；对照组T1的MAP、HR显著高于观察组(P<0.05)。两组各时点BG水平比较差异无统计学意义(P>0.05)。两组T1、T2、T3的CRP和IL-6与T0时比较差异均有统计学意义(P<0.05)。对照组T1、T2、T3的CRP和IL-6显著高于观察组(P<0.05)。观察组术后恶心、呕吐、咽喉不适及腹胀痛发生率明显低于对照组(P<0.05)。 结论 全硬联合麻醉是腹腔镜子宫全切术中一种比较理想的麻醉方法，值得临床推广应用。
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[关键词] 腰硬联合麻醉；全麻复合硬膜外阻滞；腹腔镜子宫切除术；应激反应
[中图分类号] R614 [文献标识码] A [文章编号] 1674-4721(2015)01(b)-0063-03
Application effect comparison of combined spinal epidural anesthesia and combined general epidural anesthesia in the process of total laparoscopic hysterectomy
ZHANG Hui
Department of Anesthesia，Maternal and Child Health Hospital of Jiangxi Province，Nanchang 330006，China
, 百拇医药
[Abstract] Objective To compare application effect of combined spinal epidural anesthesia and combined general epidural anesthesia in the process of total laparoscopic hysterectomy. Methods 40 patients accepted total laparoscopic hysterectomy were evenly divided into combined spinal epidural anesthesia group(control group)and combined general epidural anesthesia group(observation group)by random number table，each group of 20 cases. Concentration of blood glucose(BG)，C-reactive protein(CRP)and interleukin-6(IL-6)from venous blood as well as saturation of pulse oximetry(SpO2)，partial pressure of end-tidal CO2(PETCO2)，and hemodynamics like mean arterial pressure(MAP)，heart rate(HR)were tested at T0，T1，T2，T3 in two groups.The incidence rate of postoperative complication in both groups was observed. Results SpO2 and PETCO2 at T1，T2，T3 displayed statistical difference in comparison with that at T0 in two groups(P<0.05).In observation group，SpO2 at T1 was higher than that in control group，PETCO2 at T1 and T2 was much lower than that in control group respectively，with statistical difference(P<0.05).Compared with T0，MAP and HR in control group at T1 greatly increased with statistical difference(P<0.05).In observation group，there was no statistical difference in MAP and HR at any time point(P>0.05).MAP and HR at T1 in control group was obviously higher than that in observation group respectively(P<0.05).The level of BG at different time points in both groups had no statistical difference(P>0.05).CRP and IL-6 in both groups at T1，T2，T3 displayed statistical difference in comparison with that at T0(P<0.05).At T1，T2 and T3，CRP and IL-6 in control group was much higher than that in observation group respectively(P<0.05).The incidence rate of postoperative complication like nausea，vomiting，throat discomfort and abdominal distension and pain in observation group was greatly lower than that in control group respectively(P<0.05). Conclusion Combined general epidural anesthesia is an ideal anesthetic method in total laparoscopic hysterectomy，which is worthy of clinical promotion and application., http://www.100md.com(张惠)
, http://www.100md.com
[关键词] 腰硬联合麻醉；全麻复合硬膜外阻滞；腹腔镜子宫切除术；应激反应
[中图分类号] R614 [文献标识码] A [文章编号] 1674-4721(2015)01(b)-0063-03
Application effect comparison of combined spinal epidural anesthesia and combined general epidural anesthesia in the process of total laparoscopic hysterectomy
ZHANG Hui
Department of Anesthesia，Maternal and Child Health Hospital of Jiangxi Province，Nanchang 330006，China
, 百拇医药
[Abstract] Objective To compare application effect of combined spinal epidural anesthesia and combined general epidural anesthesia in the process of total laparoscopic hysterectomy. Methods 40 patients accepted total laparoscopic hysterectomy were evenly divided into combined spinal epidural anesthesia group(control group)and combined general epidural anesthesia group(observation group)by random number table，each group of 20 cases. Concentration of blood glucose(BG)，C-reactive protein(CRP)and interleukin-6(IL-6)from venous blood as well as saturation of pulse oximetry(SpO2)，partial pressure of end-tidal CO2(PETCO2)，and hemodynamics like mean arterial pressure(MAP)，heart rate(HR)were tested at T0，T1，T2，T3 in two groups.The incidence rate of postoperative complication in both groups was observed. Results SpO2 and PETCO2 at T1，T2，T3 displayed statistical difference in comparison with that at T0 in two groups(P<0.05).In observation group，SpO2 at T1 was higher than that in control group，PETCO2 at T1 and T2 was much lower than that in control group respectively，with statistical difference(P<0.05).Compared with T0，MAP and HR in control group at T1 greatly increased with statistical difference(P<0.05).In observation group，there was no statistical difference in MAP and HR at any time point(P>0.05).MAP and HR at T1 in control group was obviously higher than that in observation group respectively(P<0.05).The level of BG at different time points in both groups had no statistical difference(P>0.05).CRP and IL-6 in both groups at T1，T2，T3 displayed statistical difference in comparison with that at T0(P<0.05).At T1，T2 and T3，CRP and IL-6 in control group was much higher than that in observation group respectively(P<0.05).The incidence rate of postoperative complication like nausea，vomiting，throat discomfort and abdominal distension and pain in observation group was greatly lower than that in control group respectively(P<0.05). Conclusion Combined general epidural anesthesia is an ideal anesthetic method in total laparoscopic hysterectomy，which is worthy of clinical promotion and application., http://www.100md.com(张惠)