糖尿病腹部手术中全麻复合硬膜外麻醉和全麻两种麻醉方法疗效对比.docVIP

糖尿病腹部手术中全麻复合硬膜外麻醉和全麻两种麻醉方法疗效对比 　　DOI：10.16658/j.cnki.1672-4062.2016.08.086 　　[摘要] 目的 探讨全麻复合硬膜外麻醉和全麻用于糖尿病腹部手术中的疗效对比分析。 方法 接受糖尿病腹部手术中的老年患者62例，随机分为两组，观察组采全麻复合硬膜外麻醉，对照组采用全麻。观察两组麻醉前后血流动力学变化。结果 全麻复合硬膜外麻醉优于全麻（90.3% vs83.9%）。差异无统计学意义（P0.05）。术后认知障碍，深静脉栓塞发生率低于全麻（P0.05）。结论 全麻复合硬膜外麻醉，全麻均可用于老年糖尿病腹部手术，但前者并发症较少。 　　[关键词] 糖尿病；全麻复合硬膜外麻醉；全麻；疗效对比 　　[中图分类号] R587.1 [文献标识码] A [文章编号] 1672-4062（2016）04（b）-0086-02 　　Diabetes Abdominal Surgery in General Anesthesia Compound Epidural Anesthesia and General Anesthesia the Curative Effect of two Methods of Anesthesia 　　NI Li-ping 　　Taian Center of Mental Health，Taian，Shandong Province， 271000 China 　　[Abstract] Objective Discusses general anesthesia compound epidural anesthesia and general anesthesia for curative effect analysis in diabetes abdominal surgery. Methods Diabetes abdominal surgery in 62 cases of elderly patients and randomly divided into 2 groups， the observation group in general anesthesia compound epidural anesthesia， the control group with general anesthesia. Observe two groups hemodynamic changes before and after anesthesia. Result General anesthesia compound epidural anesthesia is superior to general anesthesia （90.3% vs83.9 %）. No statistical significance （P 0.05）. Postoperative cognitive impairment， lower incidence of deep vein thrombosis during anesthesia （P 0.05）. Conclusion General anesthesia compound epidural anesthesia， general anesthesia can be used in elderly diabetes abdominal surgery， but the former with less complications. 　　[Key words] Diabetes；General anesthesia compound epidural anesthesia；General anesthesia；Effect of contrast 　　糖尿病腹部手术是老年患者常见的手术之一，因存在术中出血量大，创伤刺激大等特点，加之老年患者常合并高血压，冠心病等基础疾病，增加了麻醉风险。在麻醉方式的选择上存在争议。我科采用全麻复合硬膜外麻醉和全麻用于糖尿病腹部手术进行比较，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　选择2013年1―6月施行糖尿病腹部手术老年患者62例，ASAⅡ～Ⅲ级。男性38例，女性24例。年龄65～82岁，平均年龄72岁。随机分为A组全麻复合硬膜外麻醉组，B组全麻组。各组均为31例患者。两组病人年龄，性别进行对比，差异无统计学意义。所有病人均完善检查及控制基础疾病。麻醉前均签定知情同意书。 　　1.2 麻醉方法 　　于麻醉前30 min肌注0.5 mg阿托品，0.1 mg苯巴比妥钠。司克林2 mg/kg、万可松0.08 mg/kg、芬太尼5～8