摘要
目的探讨不同麻醉方法对高血压妇科手术患者的影响。方法 2009年04月至～2011年04月期间,诊治的40例妇科手术患者,患者具有I-II期高血压病史。符合WHO诊断标准,将40例高血压妇科手术患者,随机分成单纯全麻组和硬膜外阻滞复合全麻组,每组各20例。术中对桡动脉收缩压(SBP)、平均动脉压(MAP)、心率(HR)等指标进行连续监测,并记录手术结束至清醒时间和至拔管时间。结果与单纯全麻组相比,硬膜外阻滞复合全麻组手术结束至清醒时间和至拔管时间明显降低,P<0.05,差异有统计学意义([10±4)min比(32±10)min、(16±5)比(53±18)min,均P<0.05]。与麻醉前相比,插管及拔管时,单纯全麻组插管及拔管时SBP、MAP、HR明显升高,(P<0.05);与单纯全麻组相比,硬膜外阻滞复合全麻组SBP、MAP、HR明显降低,差异有统计学意义(P<0.05)。结论硬膜外阻滞复合全麻麻醉方法能够降低高血压妇科患者的血流动力学波动,有利于患者的康复。
Objective To explore the impact of different anesthetic techniques on hypertensive patients with gynecological surgery.Methods 96 cases undergoing elective gynecological surgery in elderly patients,preoperative combining I^II hypertension,according to the WHO criteria for diagnosis,were randomly divided into general anesthesia(group A,48 cases),anesthesia combined with epidural anesthesia block(group B,48 cases).Two groups of patients were observed systolic blood pressure(SBP),mean arterial pressure(MAP) and heart rate(HR) changes before anesthesia,intubation,after extubation,and were recorded surgery to wake up the situation and adverse reactions(such as intraoperative awareness,postoperative agitation,nausea,vomiting,shoulder pain,etc.).Results SBP,MAP and HR were significantly higher than before anesthesia at the time of intubation and extubation in group A(P<0.05),group B have not significant change during the same period(P>0.05),between groups was statistically significant(P<0.05);The difference of anesthesia recovery time and postoperative adverse reactions was statistically significant in two groups(P<0.01,P<0.05).Conclusion Anesthesia combined with epidural anesthesia is safe and effective anesthesia with gynecological surgery in patients of hypertension,because it can reduce the stress response to intraoperative hemodynamic stability and anesthetic quantity,rapid postoperative recovery,as early extubation.
出处
《当代医学》
2012年第26期86-87,共2页
Contemporary Medicine
关键词
硬膜外
复合麻醉
高血压
妇科手术
general anesthesia
epidural anesthesia
hypertension
gynecological surgery
