全身麻醉联合硬膜外麻醉与单纯全身麻醉对妇科腹腔镜手术的麻醉效果比较.docVIP

全身麻醉联合硬膜外麻醉与单纯全身麻醉对妇科腹腔镜手术的麻醉效果比较 　　[摘要] 目的 比较全身麻醉联合硬膜外麻醉与单纯全身麻醉对妇科腹腔镜手术的麻醉效果。 方法 选择2015年1～6月在重庆市妇幼保健院妇科采取腹腔镜手术治疗的患者108例为研究对象，随机分为观察组和对照组，每组各54例。观察组患者行全身麻醉联合硬膜外麻醉，对照组患者行单纯全身麻醉。分别对两组患者的血流动力学变化情况，子宫松弛程度及临床指标改善情况进行对比分析。 结果 ①两组患者麻醉诱导前后心率、收缩压、舒张压等血流动力学指标比较，差异均无统计学意义（P 0.05）；观察组患者在建立气腹后、手术结束时、气管插管拔管时的心率、收缩压、舒张压等血流动力学指标均明显低于对照组，差异有统计学意义（P 0.05）。②观察组患者子宫松弛程度为优者44例（81.5%），良8例（14.8%），差2例（3.7%），对照组患者子宫松弛程度为优者33例（61.1%），良9例（16.7%），差12例（22.2%）。观察组患者子宫松弛程度为优的比例明显高于对照组，观察组患者子宫松弛程度为差的比例明显低于对照组，差异均有统计学意义（P 0.05）。③观察组患者手术时间为（89.81±10.37）min，麻醉苏醒时间为（6.07±2.29）min；对照组患者手术时间为（110.47±15.56）min，麻醉苏醒时间为（10.14±4.41）min。观察组患者手术时间及苏醒时间均明显短于对照组，差异有统计学意义（P 0.05）。 结论 全身麻醉联合硬膜外麻醉的临床麻醉效果要远远优于单纯全身麻醉，可作为较为理想的麻醉方案在临床应用及推广。 　　[关键词] 单纯全身麻醉；全身麻醉联合硬膜外麻醉；妇科；腹腔镜手术 　　[中图分类号] R614 [文献标识码] A [文章编号] 1673-7210（2016）01（b）-0129-04 　　[Abstract] Objective To compare the anesthesia effects between pure general anesthesia and general anesthesia combined epidural anesthesia in gynecological laparoscopic operation. Methods 108 cases of gynecological laparoscopic operation in Department of Anesthesiology， Chongqing Health Centre for Women and Children from January to June in 2015 were selected and divided into observation group and control group randomly， with 54 cases in each group. Patients in observation group were treated with general anesthesia combined epidural anesthesia， and patients in control group were treated with pure general anesthesia. The hemodynamic changes， uterus relaxation degree and clinical indicators improvement between the two groups were compared and analyzed. Results ①The the differences of hemodynamic indexes of heart rate， systolic pressure， diastolic blood pressure before and after induction of anesthesia between the two groups were not statistically significant （P 0.05）. The hemodynamic indexes of heart rate， systolic pressure， diastolic blood pressure on the time point of pneumoperitoneum establishing， end of the surgery， endotracheal intubation tube drawing in observation gro