[精品][经典]全麻复合硬膜外麻醉在老年患者腹腔镜胆囊切除术中的临床研究.doc

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1、[经典]全麻复合硬膜外麻醉在老年患者腹腔镜胆囊切除术中的临床研究全麻复合硬膜外麻醉在老年患者腹腔镜胆囊切除术中的临床研究【摘要】冃的探讨老年患者腹腔镜胆囊切除术用两种不同麻醉方法的临床效果。方法择期行腹腔镜胆囊切除术的老年患者80例（年龄〉60岁）,随机分为全麻组（A组）和全麻复合硬膜外麻醉组（B组）,每组各40例。记录患者入室后（T❷1）、诱导后（T❷2）、插管后即刻（T❷3）、C0❷2气腹后（T❷4）及气管拔管后R卩刻（T❷5）各时点心率（HR）、收缩压（SBP）.舒张压（DBP）的变化;记录术毕患者苏醒吋间

2、、呼之睁眼时间和拔管时间;记录拔管后即刻、10min、20min.30min伤口疼痛程度。结果B组与A组相比:B组在T❷3、T❷4、T❷5即刻的血流动力学较A组稳定，两组比较差异有统计学意义（P〈0.05）;其术后苏醒时间、呼之睁眼时间和拔管时间差异无统计学意义（卩>0.05）,但苏醒期间患者发生烦躁反应A组（13例）远高于B组（5例）,差异有统计学意义（P〈0・05）;B组拔管后各时间点VAS评分明显低于A组（P<0.05）o结论老年患者LC实施全麻复合硬膜外麻醉，能减轻术中的应激反应，血流动力学稳定,减轻患者

3、苏醒期疼痛，降低术后烦躁反应发生率，是老年患者较适宜的麻醉方法。【关键词】老年患者;腹腔镜胆囊切除术;硬膜外麻醉;全麻ThestudyofthegeneralanesthesiacombinedwithepiduralanesthesiaforagedpatientswhounderwentlaparoscopiccholecystectomyJIANGLi-qing,LIUCan-fen.HunanprovinceYiyangcentenhospitalanaesthesioligyroom,Hunan,Yiy

4、ang,413000,China[Abstract]ObjectiveToexploretheeffectsoftwodifferentanesthesiasforagedpatientswhounderwentlaparoscopiccholecystectomy.Methods80agedpatients(age>60)whounderwent1aparoscopiccholecystectomy(LC)wererandomlydividedintogeneralanesthsiagroup(groupA)a

5、ndgeneralanesthesiacombinedwithepiduralanesthesiagroup(groupB),eachgroupfor40cases.Thefollowingdataoftwogroupswererecorded:theHR,SBPandDBPatthemomentofentranceofsurgeryroom(T❷1),anesthesiainduction(T令2),rachealintubation(T^3),establishmentofpneumoperitoneum(T

6、^4)andextubation(T❷5),thetimeofpost-oeprativeanalepsia,thetimeofopeneyeswhenarousalandextubation;thedegreeofpainintheminuteofextubation,10min,20minand30minafterextubation.ResultsGroupBcomparedwithgroupA,thehemodynamicsofBgroupwasmorestableintheinstantofT❷3,T❷

7、4,T❷5,thediffereneebetweentwogroupswassinificant(P〈0.05):Thetimeofanalepsia,thetimeofopeneyeswhenarousalandextubationwasnotsinificantlydifferentbetweentwogroups(P>0.05).IngroupA(13patients)hadrestlessnessreaction,whichwasmuchmorethanBgroup(5patients)・TheVASgr

8、adeofgroupBateachtimepointafterextubationwasmuchlessthangroupA(P<0.05).ConclusionGeneralanesthesiacombinedwithepiduralanesthesiaforagedpatientswhounderwentLCcanlessenstressreactionduringo