硬膜外麻醉和全麻在腹腔镜胆囊切除术中对心血管的影响(1)
[摘要] 目的 比较硬膜外麻醉和全麻在腹腔镜胆囊切除术中对心血管的影响。 方法 统计分析我院2015年4月～2017年4月收治的80例择期行腹腔镜胆囊切除术患者的临床资料，依据麻醉方法分为硬膜外麻醉组(n=40)和全身麻醉组(n=40)，分析两组患者不同时间点的血流动力学、血浆E、NE浓度。 结果 T2时硬膜外麻醉组患者的HR显著高于全身麻醉组(P<0.05)，T3时的HR、MAP均显著低于全身麻醉组(P<0.05)；T2时硬膜外麻醉组患者的血浆E浓度显著高于全身麻醉组(P<0.05)，T3时的血浆NE浓度显著低于全身麻醉组(P<0.05)。 结论 硬膜外麻醉下腹腔镜胆囊切除术中对心血管的影响较全麻小，值得在临床推广。
[关键词] 硬膜外麻醉；全麻；腹腔镜胆囊切除术；心血管
[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701(2018)17-0109-03
Cardiovascular effects of epidural anesthesia and general anesthesia during laparoscopic cholecystectomy
LIU Liang
Department of Anesthesiology，People's Hospital of Tacheng in the Xinjiang Uygur Autonomous Region，Tacheng 834700，China
[Abstract] Objective To compare the cardiovascular effects of epidural anesthesia and general anesthesia during laparoscopic cholecystectomy. Methods The clinical data of 80 patients undergoing elective laparoscopic cholecystectomy from April 2015 to April 2017 in our hospital were statistically analyzed. The patients were divided into epidural anesthesia group(n=40) and general anesthesia group(n=40) according to the anesthetic method. Hemodynamics， plasma E， and NE concentrations of two groups at different time points were analyzed. Results The HR of patients in epidural anesthesia group at T2 was significantly higher than that of general anesthesia group(P<0.05). The HR and MAP in epidural anesthesia group at T3 were significantly lower than those of general anesthesia group(P<0.05). Plasma E concentrations in epidural anesthesia group at T2 were significantly higher than those in the general anesthesia group(P<0.05)， and plasma NE concentrations at T3 were significantly lower than those in the general anesthesia group (P<0.05). Conclusion The effect of epidural anesthesia on laparoscopic cholecystectomy is smaller than that of general anesthesia which is worthy of promotion in clinic.
[Key words] Epidural anesthesia；General anesthesia；Laparoscopic cholecystectomy；Cardiovascular
為了对腹腔镜胆囊切除术患者的心血管进行有效保护，本研究统计分析了我院2015年4月～2017年4月收治的80例择期行腹腔镜胆囊切除术患者的临床资料，对硬膜外麻醉和全麻下腹腔镜胆囊切除术中对心血管的影响进行了比较，现报道如下。
1 资料与方法
1.1 一般资料
统计分析我院2015年4月～2017年4月收治的80例择期行腹腔镜胆囊切除术患者的临床资料，纳入标准：所有患者术前均具有正常的心电图；排除标准：有内分泌疾病者。依据不同麻醉方法分为两组，即硬膜外麻醉组(n=40)和全身麻醉组(n=40)。硬膜外麻醉组患者中男23例，女17例，年龄34～71岁，平均(56.4±7.5)岁；体质量42～73 kg，平均(67.2±10.2)kg。在美国麻醉医师协会(ASA)分级方面，21例为Ⅰ级，16例为Ⅱ级，3例为Ⅲ级。全身麻醉组患者中男21例，女19例，年龄35～71岁，平均(57.1±7.4)岁；体质量43～73 kg，平均(67.8±10.6)kg。在ASA分级方面，22例为Ⅰ级，17例为Ⅱ级，1例为Ⅲ级。两组患者的一般资料比较差异无统计学意义(P>0.05)，具有可比性。见表1。, 百拇医药(刘亮)
[关键词] 硬膜外麻醉；全麻；腹腔镜胆囊切除术；心血管
[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701(2018)17-0109-03
Cardiovascular effects of epidural anesthesia and general anesthesia during laparoscopic cholecystectomy
LIU Liang
Department of Anesthesiology，People's Hospital of Tacheng in the Xinjiang Uygur Autonomous Region，Tacheng 834700，China
[Abstract] Objective To compare the cardiovascular effects of epidural anesthesia and general anesthesia during laparoscopic cholecystectomy. Methods The clinical data of 80 patients undergoing elective laparoscopic cholecystectomy from April 2015 to April 2017 in our hospital were statistically analyzed. The patients were divided into epidural anesthesia group(n=40) and general anesthesia group(n=40) according to the anesthetic method. Hemodynamics， plasma E， and NE concentrations of two groups at different time points were analyzed. Results The HR of patients in epidural anesthesia group at T2 was significantly higher than that of general anesthesia group(P<0.05). The HR and MAP in epidural anesthesia group at T3 were significantly lower than those of general anesthesia group(P<0.05). Plasma E concentrations in epidural anesthesia group at T2 were significantly higher than those in the general anesthesia group(P<0.05)， and plasma NE concentrations at T3 were significantly lower than those in the general anesthesia group (P<0.05). Conclusion The effect of epidural anesthesia on laparoscopic cholecystectomy is smaller than that of general anesthesia which is worthy of promotion in clinic.
[Key words] Epidural anesthesia；General anesthesia；Laparoscopic cholecystectomy；Cardiovascular
為了对腹腔镜胆囊切除术患者的心血管进行有效保护，本研究统计分析了我院2015年4月～2017年4月收治的80例择期行腹腔镜胆囊切除术患者的临床资料，对硬膜外麻醉和全麻下腹腔镜胆囊切除术中对心血管的影响进行了比较，现报道如下。
1 资料与方法
1.1 一般资料
统计分析我院2015年4月～2017年4月收治的80例择期行腹腔镜胆囊切除术患者的临床资料，纳入标准：所有患者术前均具有正常的心电图；排除标准：有内分泌疾病者。依据不同麻醉方法分为两组，即硬膜外麻醉组(n=40)和全身麻醉组(n=40)。硬膜外麻醉组患者中男23例，女17例，年龄34～71岁，平均(56.4±7.5)岁；体质量42～73 kg，平均(67.2±10.2)kg。在美国麻醉医师协会(ASA)分级方面，21例为Ⅰ级，16例为Ⅱ级，3例为Ⅲ级。全身麻醉组患者中男21例，女19例，年龄35～71岁，平均(57.1±7.4)岁；体质量43～73 kg，平均(67.8±10.6)kg。在ASA分级方面，22例为Ⅰ级，17例为Ⅱ级，1例为Ⅲ级。两组患者的一般资料比较差异无统计学意义(P>0.05)，具有可比性。见表1。, 百拇医药(刘亮)