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1、老年高血压患者腹腔镜胆囊切除术麻醉方式选择研究张静、毛安琼泸州医学院附属医院麻醉科646000摘要:目的探讨静吸复合全身麻醉在老年高血压患者腹腔镜肭囊切除术中的麻醉效果;方法研究对象选自2014年1月至2015年6月于我院肝胆外科就诊的胆囊结石患者80例,随机分为研究组、对照组各40例。研究组应用全身麻醉联合硬膜外麻醉,对照组单纯应用全身麻醉。采用记录麻醉前(T0)、插管后即刻(T1)、气腹后lOmin(T2)、拔管前即刻(T3)的SBP、DBP、心率(HR)、血氧饱和度(SpO2)。比较两组患者在呼吸恢复时间、睁眼时间、拔管时间和定向力恢复时
2、间的差异;结果插管后即刻(T1)、气腹后lOmin(T2)、拔管前即刻(T3)三个时间段研究组的SBP、DBP均明显低于对照组,HR明显高于对照组。各时段两组SP02水平差异无统计学意义(P〉0.05)。研究组患者术后呼吸恢复时间(7.82±3.13)min、睁眼时间(7.82±3.13)min,拔管时间(16.72±4.26)min,定向力恢复时间(19.56±5.25)min,各项指标均明显优于对照组(P<0.05或P<0.01);结论老年高血压患者行腹腔镜胆囊切除术应用静吸复合全身麻
3、醉,可有效维持患者血流动力学指标的稳定性,麻醉效果好,术后恢复快,可作为临床应用的优先选择。关键词:腹腔镜胆囊切除术;静吸复合;全身麻醉;高血压;老年Studyonanesthesiaoflaparoscopiccholecystectomyforelderlypatientswithhypertension[Abstract]:Objective:Toinvestigatetheanestheticeffectofintravenousanesthesiacombinedwithgeneralanesthesiainagedpatientsw
4、ithhypertension;Methods:FromJanuary2014toJune2015inourhospitaldepartmentofhepatobiliarysurgery,80casesofpatientswithgallbladderstoneswererandomlydividedintostudygroupandcontrolgroup,40casesineachgroup.Theresearchgroupwastreatedwithgeneralanesthesiacombinedwithepiduralanesthe
5、sia,andthecontrolgroupwastreatedwithgeneralanesthesia.Therecordbeforeanesthesia(TO),afterintubationimmediately(Tl),pneumoperitoneumafter10min(T2),drawingtubeimmediatelybefore(T3)ofSBP,DBP,heartrate(HR),oxygensaturation(SpO2).Thedifferencebetweenthetwogroupsofpatientswitheyeo
6、peningtime,extubationtimeandrecoverytime,recoverytimeinbreathing;Results:Afterintubationimmediately(Tl),pneumoperitoneumafter10min(T2),drawingtubeimmediatelybefore(T3)threetimestudygrouptheSBPandDBPweresignificantlylowerthanthatofthecontrolgroup,HRwassignificantlyhigherthant
7、hatofthecontrolgroup.TherewasnosignificantdifferenceinSPO2levelsbetweenthetwogroups(P>0.05).Patientsinthestudygroupwerebreathingrecoverytime(7.82+3.13)min,eyeopeningtime(7.82+3.13)min,theextubationtime(16.72+4.26)min,orientationrecoverytime(19.56+5.25)min,theindicatorswer
8、esignificantlybetterthanthecontrolgroup(P<0.05orP<0.01);Conclusions:E