不同麻醉方式对急性腹膜炎伴感染性休克患者围麻醉期的影响.pdf

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1、·1328·中华医院感染学杂志2013年第23卷第6期ChinJNosocomiolVo1．23No．62013·论著·不同麻醉方式对急性腹膜炎伴感染性休克患者围麻醉期的影响吴风罡(浙江省肿瘤医院麻醉科，浙江杭州310000)摘要：目的探讨气管内插管静吸复合全麻与硬膜外阻滞+复合全麻两种不同麻醉方式对急性腹膜炎合并感染性休克患者围麻醉期的影响。方法选择急性腹膜炎合并感染性休克患者37例，随机分为气管内插管静吸复合全麻组(静吸组)17例、硬膜外阻滞+复合全麻组(阻滞组)20例，分别观察两组在各个麻醉时期循环系数的变化及不良反应发生情况。结果入室时两组心

2、率、动脉平均压(MAP)及血氧饱和度(SpOz)差异均无统计学意义；进入麻醉诱导期，两组心率明显下降，SpO仍能维持于99；拔管时，静吸组心率高于阻滞组(P

3、rianesthesia0fpatientscomplicatedwithacuteperitonitisandsepticshockWuFeng—gang(ZejiangProvincialTumorHospital，Hangzhou，Z^ejiang310000，China)Abstract：OBJECTIVETodiscusstheeffectsofintratrachealgeneralanesthesiaandgeneralanesthesiacombinedwithepiduralblockontheperianesthesiaofthe

4、patientswithacuteperitonitiscombinedwithsepticshock．METHODSAtotalof37patientswithacuteperitonitiscombinedwithsepticshockwereselectedandwererandomlydividedintotheintratrachealgeneralanesthesiagroup(thecontrolgroup)with17casesandthegeneralanesthesiacombinedwithepiduralblock(theco

5、mbinationgroup)with20cases．Thechangesofcirculatingcoefficientandtheincidenceofadversereactionsinvariousperiodsofanesthesiawereobserved．RESULTSThedifferenceintheheartrate，meanarterypressure(MAP)，ortheOxygensaturation(SpO2)betweenthetWOgroupswasnotstatisticallysignificant．Inthein

6、ductionofanesthesia，theheartratesofbothgroupsweresignificantlydecreased，Sp02remained99．Atthemomentofextubation，theheartrateofthecontrolgroupwashigherthanthatofthecombinationgroup(P<0．05)．Invariousperiodsofanesthesia，theMAPofthecontrolgroupwashigherthanthatofthecombinationgroup．

7、Thecombinationgrouphadabetteranestheticeffectandlessadversereactionthandidthecontrolgroup．CONCLUSIONThegeneralanesthesiacombinedwithepiduralblockcanachievebetteranestheticeffectintheemergencysurgeryfortheacuteperitonitiscomplicatedwithsepticshock，whichisworthytobepromoted．Keywo

8、rds：Acuteperitonitis；Septicshock；Anesthesiaapproach；Pe