腰硬联合阻滞复合浅全身麻醉与插管全身麻醉在妇科腹腔镜手术中的对比研究.doc

《腰硬联合阻滞复合浅全身麻醉与插管全身麻醉在妇科腹腔镜手术中的对比研究.doc》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、腰硬联合阻滞复合浅全身麻醉与插管全身麻醉在妇科腹腔镜手术中的对比研究作者：刘有才　蒋孟杰　李军利　王宁　刘峰　刘鹏　　【摘要】目的探讨腰硬联合阻滞复合浅全身麻醉与插管全身麻醉在妇科腹腔镜手术中的麻醉效果及可行性。方法选择58例患者,分为腰-硬联合阻滞（A组）和插管全身麻醉（B组）各29例,分别记录气腹前、气腹后10、20、30min排气后10min的BP、HR、RR、SpO2、PETCO2,同时观察患者的反应及术后苏醒情况。结果A组CO2气腹后,RR加快、PETCO2升高差异有统计学意义（P<0．01）,仍可维持正常范围,而SpO2变化差异无统计学意义（P>

2、;0．05）;B组气腹时应激反应活跃,DBP、SBP、HR与气腹前比较差异有统计学意义（P<0．01）,两组患者在气腹30min后,各项指标均有所改善,排气后10min各项指标与气腹前比较差异无统计学意义（P>0．05）,A组比B组术后苏醒快差异有统计学意义（P<0．01）,所有患者均顺利完成手术,未发生麻醉并发症。结论在妇科腹腔镜手术中,应用腰-硬联合阻滞复合浅全身麻醉比插管全身麻醉能更好地控制机体的应激反应,术后苏醒快,是一种效果佳、可行、实用的麻醉方法。　　【关键词】腰-硬联合阻滞麻醉,全身麻醉；妇科手术；腹腔镜　　　　　　【Abstrac

3、t】ObjectiveTodiscusstheanaesthesiaeffectanditsfeasibilityofCSEAassistedbytheshallowandgeneralveinanesthesiaandthepuretube-insertinggeneralanesthesiainthegynecologyperitoneoscopesurgery.MethodsTochoose58casesofpatients,stochasticallydividethemintotheCSEAgroup（groupA）andtube-insertinggene

4、ralanesthesiagroup（groupB）,with29casesineachgroup,thenseparatelymonitorandrecordtheirDBP,SBP,HR,RR,SpO2，PETCO210,20,30minutesbeforeandafterpneumoperitoneumand10minutesafterexhausting,thenobservetheresponseofthe2groupsofpatientsafterpneumoperitoneumandconsciousness-regainingsituationa

5、ftersurgery.ResultsAfterCO2pneumoperitoneum,RRofthepatientsingroupAspeedsup,theirPETCO2elevatesobviously（P<0．01）;theresponseofthepatientsingroupBbecomesactivewhenpneumoperitoneum,thechangeofDBP,SBP,HRismoreremarkablethanthatbeforepneumoperitoneum（P<0．01）.Eachtargetofthetwogroup

6、sofpatientshasbeenimproved30minutesafterpneumoperitoneum.Eachtargetisquiteclosetothatbeforepneumoperitoneum10minafterexhausting.TheconsciousnessofthepatientsingroupAregainsmorequicklycomparedtothoseingroupBafterthesurgery（P<0．01）.Allthegynecologyperitoneoscopesurgerytothepatientshasb

7、eensmoothlydone,noanaesthesiacomplicationoraccidentshavehappened.ConclusionsInthegynecologyperitoneoscopesurgery,themethodofCSEAassistedbytheshallowandgeneralveinanesthesiacan3moreeasilycontroltheresponseoftheorganismcomparedtothemethodoftube-insertinggeneralanesthesia.Theconsc