腰麻硬膜外联合麻醉在阴式全子宫切除术中临床应用.docVIP

腰麻硬膜外联合麻醉在阴式全子宫切除术中临床应用 　　[摘要] 目的 探讨腰麻硬膜外联合麻醉(CSEA)在阴式全子宫切除术中的应用效果及其安全性。方法 选择80例择期行阴式全子宫切除术患者，随机分成观察组(CSEA)和对照组(EA)，每组各40例；麻醉药物0.5%布比卡因1.5-2ml、0.5%耐乐品(20.5±6.8)ml。记录所有患者麻醉效果、肌松效果和不良反应等情况；监测血压、心率、ECG、氧饱和度变化情况。结果 观察组麻醉效果明显优于对照组(P＜0.01)；牵拉宫颈时，对照组HR明显减慢，与观察组比较有统计学意义(P＜0.05)；麻醉后两组血压均有所下降，与观察组相比，对照组下降幅度更加明显(P＜0.05)。结论 腰麻硬膜外联合麻醉起效快，不良反应低，是临床上阴式全子宫切除术安全有效的方法。 　　[关键词] 腰麻硬膜外联合麻醉； 硬膜外麻醉； 阴式全子宫切除术 　　[中图分类号] R614 [文献标识码] B [文章编号] 1005-0515（2012）-02-017-01 　　 　　Comparison of Clinical using Combined Spinal-epidural Anesthesia in Transvaginal Hysterectomy 　　Li Yaohui 　　(Anaesthesia of FanYu Shi-qiao hospital,Guangzhou Guangdong Guangzhou 511400 China) 　　[Abstract] Objective To discuss the effect and safety of combined spinal-epidural anesthesia in transvaginal hysterectomy.Methods 80 cases of patients with transvaginal hysterectomy were choosen and randomly divided into observation group(CSEA) and control group(EA),each group of 40 cases.Anesthetic drugs is 0.5% bupivacaine 1.5-2ml＋0.5% ropivacaine(20.5±6.8)ml.Anaesthetic effect、muscle relaxation effect and adverse reaction were recorded.All of the patients were monitoring the BP、HR、ECG、SPO2.Results The observation group was better than control anaesthetic effect (P＜0.01);Pull the cervix,the control group HR obvious to slow, and the observation group has more statistically significant (P0.05);The two groups after anesthesia SBP and DBP all declined,but the control group decline was more obvious than the observation group (P0.05).Conclusions Combined spinal-epidural anesthesia has the effect to fast,adverse reactions low characteristic,can be very safely used on transvaginal hysterectomy. 　　[Key words] combined spinal-epidural anesthesia； epidural anaesthesia； transvaginal hysterectomy 　　 　　 腰麻硬膜外联合麻醉(Combined Spinal-epidural Anesthesia,CSEA)结合腰麻和硬膜外麻醉的优点，具有起效快、麻醉效果确切、镇痛和肌松完善、麻醉时间延长、术后镇痛好等优点，目前已广泛应用于临床[1-3]。我们于2009年1月-2010年12月对40例患者采用CSEA行阴式全子宫切除术，取得满意麻醉效果，现报告如下： 　　1 临床资料 　　1.1 一般资料 80例ASAⅠ-Ⅲ级经阴道行全子宫切除术患者，年龄35-68岁，平均(4