针麻复合气管内麻醉在腹腔镜胆囊切除术中应用.docVIP

针麻复合气管内麻醉在腹腔镜胆囊切除术中应用 　　(上海中医药大学附属岳阳中西医结合医院麻醉科,上海200437) 　　[摘要]方法: 34例腹腔镜胆囊切除术 病人分为3组,Ⅰ组单纯气管内麻醉;Ⅱ组硬膜外阻滞复合气管内麻醉;Ⅲ组针麻复合气管 内麻醉。监测3组病人围术期血流动力学变化情况。 　　结果:Ⅲ组波动最小(P0.0 5),且麻醉药用量减少,拔管提前(P0.01)。 　　结论:针麻复合气管内麻醉既减少麻醉药用量又对机体有调整 作用,病人苏醒迅速,拔管时间缩短,使循环系统更稳定。? 　　[主题词]胆囊切除术,腹腔镜;针药复合麻醉;针刺麻醉手术;麻醉,气管内? 　　Application of Combined Acupuncture and Intratracheal Anesthesia in Cholecystect omy under Laparoscopy?Gu Chenyi,Cai Yunbiao(Affiliated Yueyang Hospital of Combined Traditiona l Chinese Medicine and Western Medicine, Shanghai University of TCM,Shanghai 200 437) 　　[Abstract]PurposeTo investigate t herapeutic effect of combined acupunctur e and intratracheal anesthesia.M ethodsThirty?four cases of chol ecystectomy under laparoscopy were divi ded into 3 groups:Simple intratracheal a nesthesia(Group Ⅰ),Combined extradural b lock and intratracheal anesthesia(Group Ⅱ)and Combined acupuncture and in tratracheal anesthesia(Group Ⅲ).Changes of hemody namics in operative period were monitore d in the 3 groups.ResultsThe fluctuation of hemodynamics was the lest(P0.05),and dosage of anesthetics was reduced and the tube was removed in adva nce in the group Ⅲ.ConclusionCombined acup uncture and intrathacheal anesthesia red uces dosage of anesthetics and has regu lative action on the organism;The patien t awakes quickly,the time of removing th e tube is shortened and blood circulatio n is more stable.? 　　[Key words]Cholecystect omy,Laparoscopic;Combined Acup Medic Ane sthesia;Acup Anesthesia Operation;Anesth esia,Intratracheal? 　　单纯针麻存在镇痛不完善等缺 点,而针麻与多种形式的麻醉方法相结合取得了良好效果[1,2]。本文对比观察 气管内麻醉、硬膜外阻滞复合气管内麻醉、针麻复合气管内麻醉下行腹腔镜胆囊切除术(L C)对血流动学和术后清醒的影响,以期为LC选择理想的麻醉方法提供参考依据。? 　　 　　1资料与方法? 　　 　　1.1一般资料? 　　全组34例均系胆囊结石或胆囊息肉患者,择期行LC。术前检查均无明显心肺功能异常, A SA(美国麻醉医师协会病情估计分级)Ⅰ～Ⅱ级,随机分为3组。气管内麻醉组(Ⅰ组) 12例 ,男3例,女9例;年龄60.00±6.73岁;体重60.92±8.34 kg。硬 膜外阻滞复合气管 内麻醉组(Ⅱ组)12例,男4例,女8例;年龄58.92±12.21岁;体重60. 21±9.69 kg 。针麻复合气管内麻醉组(Ⅲ组)10例,男7例,女3例;年龄56.50±10.62 岁;体重64.20±6.60 kg。? 　　1.2麻醉方法? 　　3组患者术前均肌注苯巴比妥钠0.1 g、阿托品0.5 mg。Ⅰ组全麻诱导静注