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1、Spinocath导管针连续腰麻在肾移植手术中的应用价值62JournalofChinesePhysician,January,2007,Vol9,NolSpinocath导管针连续腰麻在肾移植手术中的应用价值周俊,仲吉英,李恒,杨承祥(广东省佛山市第一人民医院麻醉科,广东佛山528000)【摘要】目的研究spinocath导管针连续腰麻用于肾移植手术的临床应用效果.方法肾移植手术的病人60例,ASAI-III级,随机分为连续硬膜外(CEA)组和连续腰麻(CSA)纽,术后均接微量输液泵进行术后镇痛.比较2组麻醉
2、效果,麻醉过程中血流动力学变化,术中,术后并发症的发生,术后镇痛的效果以及应用肾功能生化评价两种麻醉方法时移植肾功能的影响.结果病人阻滞感觉神经起效时间,运动神经阻滞评分(MBS评分),术中辅助用镇痛药和多巴胺的使用,术中平均动脉压(MAP)下降程度,术后镇痛视觉模拟评分(VAS评分),术后24,48h尿量,术中出尿时尿N一乙酰.一D一氨基葡萄糖苷酶(NAG)浓度,术后24h血尿素氨(BUN),肌酐(cr),B-微球蛋白(32"MG)以及尿NAG,视黄醇结合蛋白(RBP)浓度组间比较差异均有统计学意义(P<
3、;O.O5).结论spinocath导管针连续腰麻较连续硬膜外麻醉比较,具有起效迅速,局麻药用量少,阻滞完善,术后镇痛效果好等优点,并有助于移植肾功能的改善.[关键词]肾移植;导管插入术/仪器和设备;麻醉.脊椎TheapplicationofcontinuousspinalanesthesiawithspinocathcatheterneedleinkidneytransplantationZHOUJun,ZHONGJi—ylng,LIHeng,YANGCheng—xiang.DepartmentofAnest
4、hesiology,TheFirstPeopleHospitalOfFoshan,Foshan528000,China【Abstract】0bjectiveToevaluatetheclinicaleffectsofcontinuousspinalanesthesiawithspinocathcatheterneedleinkidneytrans—plantations.MethodsSixtyASAI—IIIpatientsaged25～5Oyearsoldundergoingkidneytransplant
5、ationswererandomlyassignedtotwoanestheticgroupsofthirtypatientseach:group1wascalledCEA(continuousepiduralanesthesia)group,groupI1wascalledCSA(continu—OUSspinalanesthesia)group,Infusionpumpwasusedafteroperationinbothgroups.Theeffectofanesthesia,thechangeofhem
6、odynamicsinthecourseofanesthesia,theoccurrenceofcomplicationsinoperationandpostoperation,theeffectofpostoperativeanalgesiaaswellasthetransplantrenalfunctionwerecomparedbetweenthetwoanesthesiagroups.ResultsThereWaSsignificantdifferencebetweenthetwogroupsinter
7、msofthetimetohaveblocksensorynerveeffect,MBSscores{theblockingSCO~Sofmotornerve},theusageofassistedpain—killeranddopamineinsurgery,thedecreaseofMAP(meanarterialbloodpressure)inoperation,VAS(visualanaloguescale)ofpostoperativean'algesia,theurinevolumesof24and
8、48hoursafteroperation,thelevelofNAG(n—acetylB—d—glucosaminidase)intheurineduringopera—tion,BUN(ureanitrogen),Cr(creatinine)andB2一MG(132-microglobulin)inbloodandRBP(retinolbindingprotein)andNAGin
