摘要
目的：比较不同麻醉方法对食管癌患者行胸腔镜联合腹腔镜下食管癌根治术麻醉效果和术后康复的影响。方法选择择期行食管癌根治手术的男性患者30例，年龄55~70岁，ASA Ⅰ~Ⅱ级，随机分为连续硬膜外复合双腔管全身麻醉组（ S组）和连续硬膜外复合单腔管全身麻醉组（ D组），每组15例。观察两组术中手术时间、单/双肺通气低氧血症发生率、晶体输注量、胶体输注量、尿量及术后肺部并发症、住院时间、硬膜外术后镇痛效果。结果双腔管组（S组）患者术中低氧血症发生率明显高于单腔管组（D组），差异有统计学意义（P﹤0.05）；双腔管组（S组）患者术后肺部并发症发生率明显高于单腔管组（D组），差异有统计学意义（P﹤0.05）。双腔管组（ S组）和单腔管组（ D组）采用硬膜外镇痛（ PCEA）均可获得满意镇痛效果，且不良反应低。结论胸腹联合腔镜下行食管癌根治术的患者，采用连续硬膜外复合全身麻醉，综合各种麻醉操作的优点，优先考虑单腔管全身麻醉，硬膜外术后镇痛，限制性输液方案，可减轻围术期应激反应，节约全身麻醉药的用量，使患者全身麻醉苏醒地更彻底，减少患者术中和术后的并发症，为患者更快康复创造条件。
Objective To compare the effect of different anesthetic management of combined thoracoscopic and laparoscopic radical esophagectomy. Methods Thirty ASAⅠorⅡpatients undergo-ing elective combined thoracoscopic and laparoscopic esophagectomy aged from 55 to 70 were randomly divided into two groups,with 15 cases in each group. The patients of group S were intubated with left double-lumen tube combined with continuous epidural anesthesia and the patients of group D were intuba-ted with single-lumen tube combined with continuous epidural anesthesia. The operating time,the rate of hypoxia in single and double lung ventilation,the amount of colloid fluid infused and crystal fluid in-fused,urinary volume were recorded. The postoperative pneumonia rate,length of hospital stay and the effect of epidural analgesia were collected and analyzed. Results Patients of group S had higher rate of hypoxia and postoperative pneumonia rate compared with the patients of group D. Epidural analgesia effect was satisfying in group S and group D. Conclusions Thoracoscopic laparoscopic combined with endoscopic esophageal cancer radical resection in patients with continuous epidural anesthesia combined with general anethesia,the advantages of general anesthesia,giving priority to single lumen tube under general anesthesia,epidural postoperative analgesia,limiting infusion scheme,can reduce peri operative stress response,save the dosage of anesthesia,make the patients during recovery from general anesthesia to more thoroughly,reduce complications during and after surgery,to create the conditions for the pa-tients recover faster.
出处
《中国实用医刊》
2016年第15期26-28,共3页
Chinese Journal of Practical Medicine
关键词
食管癌
胸腔镜
腹腔镜
麻醉
Esophagectomy
Thoracoscopy
Laparoscopy
Anesthesia
