腹腔镜胆囊切除术麻醉方法及护理探讨(1)
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【摘要】 目的 探讨腹腔镜胆囊切除术麻醉方法以及护理。方法 将我院自2008年11月至2010年11月收治的119例腹腔镜下胆囊切除术患者根据麻醉方法分为异丙酚组和七氟醚组，其中异丙酚组60例，七氟醚组59例，比较两者在维持生命体征的稳定程度和麻醉恢复速度两方面的差异，探讨两种麻醉方法的效果，同时对相应的护理措施进行总结。结果 七氟醚组在维持生命体征的稳定程度方面优于异丙酚组，异丙酚组在麻醉恢复速度方面优于七氟醚组，两者各有优势。结论 两种麻醉方法的麻醉效果均较为明显，且各有优势。七氟醚麻醉在维持生命体征方面更平稳，异丙酚麻醉在麻醉恢复速度方面更快。做好术前护理、术后并发症的观察和护理是护理工作取得良好效果的关键。
【关键词】
腹腔镜；胆囊切除术；麻醉方法；护理
Analysis of laparoscopic cholecystectomy anesthesia and nursing methods
HU Jie-yun.Peoples Hospital Longchuan County, Heyuan City, Guangdong Province, Guangdong 517300,China
【Abstract】 Objective
To discussion laparoscopic cholecystectomy anesthesia and nursing methods. Methods From November 2008 to 2010 November in our hospital 119 cases of laparoscopic cholecystectomy treated under propofol anesthesia were divided into the sevoflurane group and the propofol group, 60 cases in the sevoflurane group and 59 cases in the sevoflurane group. Differences were compared in maintaining the stability of vital signs and anesthetic recovery rate, discussing the effect of two kinds of anesthesia and summarizing the corresponding measures of care. Results the sevoflurane group is better than propofol group in the maintenance of the stability of vital signs, and the propofol group is better than the sevoflurane group in the speed of recovery from anesthesia, so both had their advantages. Conclusion The two ways of anesthesia anesthetic effects are more obvious, and had their own advantages. Sevoflurane was more stable in the maintenance of vital signs, and propofol anesthesia has faster speed of recovery from anesthesia. Good preoperative care, postoperative complications observation and nursing care is key for good results.
【Key words】
Laparoscopy; Cholecystectomy; Anesthesia; Care
作者单位：517300广东省河源市龙川县人民医院
近年来随着腹腔镜下胆囊切除术的广泛开展，麻醉方法的快速有效性以及护理配合的重要性已经成为热点话题[1]。本文将对临床常用的异丙酚麻醉和七氟醚麻醉进行比较分析，并总结护理配合的经验。现报告如下。
1 一般资料
将我院自2008年11月至2010年11收治的119例腹腔镜下胆囊切除术患者作为观察对象，其中，男49例，女70例，年龄36～71岁，平均52.1岁。在患者知情同意的前提下，根据麻醉方法不同分为异丙酚组和七氟醚组，其中异丙酚组60例，七氟醚组59例。两组患者在性别、年龄以及病灶部位等方面比较，差异无统计学意义(P>0.05)，具有可比性。
2 麻醉方法
2.1 异丙酚组
静脉注射异丙酚2 mg/kg，维库溴胺0.15 mg/kg，芬太尼3 μg/kg。气管插管接呼吸机，保持呼吸频率12次/min，潮气量8 ml/kg。术中续泵异丙酚和瑞芬太尼。
2.2 七氟醚组
将7%七氟醚通入回路并充满，将氧流量控制在8 L/min ......
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