全身麻醉联合硬膜外麻醉在宫颈癌手术中的应用及效果评价(1)
摘要：目的 分析全身麻醉聯合硬膜外麻醉对宫颈癌手术患者的麻醉效果、应激反应及不良事件。方法 选取2015年7月～2017年7月在我院接受腹腔镜术治疗的84例宫颈癌患者临床资料，按照随机数表法分两组，每组42例。对照组行全麻，观察组行全麻+硬膜外麻醉，比较两组麻醉合格率、异氟醚用量、麻醉苏醒时间，麻醉诱导后、建立气腹后、术毕时的应激反应及不良事件发生。结果 观察组麻醉合格率为92.85%，高于对照组的71.43%，且观察组异氟醚的用量为(16.21±4.11)ml较对照组的(30.74±5.74)ml少，麻醉苏醒时间为(10.21±2.43)min较对照组的(16.91±1.74)min短，差异均有统计学意义(P<0.05);麻醉诱导后、建立气腹后、术毕时的观察组HR分别为(80.64±7.53) 次/min、(77.47±9.78) 次/min、(78.52±7.92)次/min低于对照组的(91.39±8.92)次/min、(94.69±7.80)次/min、(93.68±8.47)次/min;观察组SBP分别为(138.26±11.21) mmHg、(143.23±15.84) mmHg、(145.74±14.09)mmHg，低于对照组的(146.79±10.41) mmHg、(152.76±14.18) mmHg、(156.18±10.21)mmHg，DBP分别为(76.03±5.26) mmHg、(77.92±8.71) mmHg、(79.81±9.23)mmHg，低于对照组的(82.56±6.37) mmHg、(93.68±8.34) mmHg、(92.31±9.57) mmHg (P<0.05);观察组术后不良反应率(11.90%)低于对照组(30.95%)(P<0.05)。结论 全麻联合硬膜外麻醉用于宫颈癌手术的效果良好，有利于稳定患者术中心率、血压，减少手术应激，且术后不良反应少。
, http://www.100md.com
关键词：宫颈癌;全麻;硬膜外麻醉;应激反应;不良反应
中图分类号：R614;R737.33 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.01.037
文章编号：1006-1959(2019)01-0122-04
Application and Evaluation of General Anesthesia Combined with Epidural Anesthesia in
Cervical Cancer Surgery
XING Jun
, 百拇医药
(Department of Anesthesiology，the First Hospital of Danjiangkou City，Danjiangkou 442700， Hubei，China)
Abstract：Objective To analyze the anesthetic effect， stress response and adverse events of general anesthesia combined with epidural anesthesia in patients with cervical cancer surgery. Methods The clinical data of 84 patients with cervical cancer who underwent laparoscopic surgery in our hospital from July 2015 to July 2017 were selected and divided into two groups according to the random number table method， 42 cases in each group. The control group underwent general anesthesia. The observation group underwent general anesthesia + epidural anesthesia. The anesthetic rate， isoflurane dosage， anesthesia recovery time， post-anesthesia induction， post-pneumoperitoneum， and postoperative stress response were compared. Adverse events occurred. Results The anesthesia rate of the observation group was 92.85%， which was higher than that of the control group (71.43%). The amount of isoflurane in the observation group was (16.21±4.11) ml less than that of the control group (30.74±5.74) ml， and the anesthesia recovery time was (10.21±2.43)min was shorter than the control group (16.91±1.74) min，the difference was statistically significant (P<0.05). The HR of the observation group after induction of anesthesia， after establishment of pneumoperitoneum and at the time of surgery were (80.64±7.53). ) times / min， (77.47 ± 9.78) times / min， (78.52 ± 7.92) times / min lower than the control group (91.39 ± 8.92) times / min， (94.69 ± 7.80) times / min， (93.68 ± 8.47) times/min; the SBP of the observation group were (138.26±11.21) mmHg， (143.23±15.84) mmHg， (145.74±14.09) mmHg， which was lower than that of the control group (146.79±10.41) mmHg， (152.76±14.18) mmHg， ( 156.18±10.21)mmHg， DBP were (76.03±5.26) mmHg， (77.92±8.71) mmHg， (79.81±9.23) mmHg， which was lower than that of the control group (82.56±6.37) mmHg， (93.68±8.34) mmHg， ( 92.31±9.57) mmHg (P<0.05); the adverse reaction rate (11.90%) in the observation group was lower than that in the control group (30.95%) (P<0.05). Conclusion General anesthesia combined with epidural anesthesia is effective for cervical cancer surgery， which is beneficial to stabilize the patient's central rate， blood pressure， surgical stress， and less postoperative adverse reactions., http://www.100md.com(邢均)
, http://www.100md.com
关键词：宫颈癌;全麻;硬膜外麻醉;应激反应;不良反应
中图分类号：R614;R737.33 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.01.037
文章编号：1006-1959(2019)01-0122-04
Application and Evaluation of General Anesthesia Combined with Epidural Anesthesia in
Cervical Cancer Surgery
XING Jun
, 百拇医药
(Department of Anesthesiology，the First Hospital of Danjiangkou City，Danjiangkou 442700， Hubei，China)
Abstract：Objective To analyze the anesthetic effect， stress response and adverse events of general anesthesia combined with epidural anesthesia in patients with cervical cancer surgery. Methods The clinical data of 84 patients with cervical cancer who underwent laparoscopic surgery in our hospital from July 2015 to July 2017 were selected and divided into two groups according to the random number table method， 42 cases in each group. The control group underwent general anesthesia. The observation group underwent general anesthesia + epidural anesthesia. The anesthetic rate， isoflurane dosage， anesthesia recovery time， post-anesthesia induction， post-pneumoperitoneum， and postoperative stress response were compared. Adverse events occurred. Results The anesthesia rate of the observation group was 92.85%， which was higher than that of the control group (71.43%). The amount of isoflurane in the observation group was (16.21±4.11) ml less than that of the control group (30.74±5.74) ml， and the anesthesia recovery time was (10.21±2.43)min was shorter than the control group (16.91±1.74) min，the difference was statistically significant (P<0.05). The HR of the observation group after induction of anesthesia， after establishment of pneumoperitoneum and at the time of surgery were (80.64±7.53). ) times / min， (77.47 ± 9.78) times / min， (78.52 ± 7.92) times / min lower than the control group (91.39 ± 8.92) times / min， (94.69 ± 7.80) times / min， (93.68 ± 8.47) times/min; the SBP of the observation group were (138.26±11.21) mmHg， (143.23±15.84) mmHg， (145.74±14.09) mmHg， which was lower than that of the control group (146.79±10.41) mmHg， (152.76±14.18) mmHg， ( 156.18±10.21)mmHg， DBP were (76.03±5.26) mmHg， (77.92±8.71) mmHg， (79.81±9.23) mmHg， which was lower than that of the control group (82.56±6.37) mmHg， (93.68±8.34) mmHg， ( 92.31±9.57) mmHg (P<0.05); the adverse reaction rate (11.90%) in the observation group was lower than that in the control group (30.95%) (P<0.05). Conclusion General anesthesia combined with epidural anesthesia is effective for cervical cancer surgery， which is beneficial to stabilize the patient's central rate， blood pressure， surgical stress， and less postoperative adverse reactions., http://www.100md.com(邢均)