摘要
目的探讨全身麻醉联合硬膜外麻醉对腹腔镜下胆囊切除术患者肺部感染及应激反应的影响。方法选取我院2017年4月至2019年5月行腹腔镜下胆囊切除术患者102例,根据麻醉方案的不同分为全身麻醉组(实施全身麻醉)和复合麻醉组(实施全身麻醉联合硬膜外麻醉),各61例。观察比较两组患者经过不同麻醉方式后的麻醉起效时间、术后苏醒时间、自主呼吸恢复时间、不同时间点白细胞计数、皮质醇、C反应蛋白、血糖水平以及肺部感染发生率。结果复合麻醉组患者麻醉起效时间、术后苏醒时间及自主呼吸恢复时间均短于全身麻醉组,肺部感染发生率显著低于全身麻醉组(P<0.05);复合麻醉组患者T2(气腹后10 min)、T3(气腹后30 min)、T4(撤除气腹后10 min)时间点白细胞计数、皮质醇、C反应蛋白、血糖水平与全身麻醉组比较差异有统计学意义(P<0.05)。结论全身麻醉结合硬膜外麻醉能够有效加快腹腔镜下胆囊切除术患者的术后苏醒时间,抑制机体应激反应,减少肺部感染的发生风险。
Objective To investigate the effect of general anesthesia combined with epidural anesthesia on pulmonary infection and stress response in patients undergoing laparoscopic cholecystectomy.Methods A total of 102 patients who underwent laparoscopic cholecystectomy in our hospital from April 2017 to May 2019 were selected and divided into general anesthesia group(implement general anesthesia)and compound anesthesia group(implement general anesthesia combined with epidural anesthesia)according to different anesthesia plans,each group with 61 cases.Anesthesia onset time,postoperative recovery time,spontaneous respiration recovery time,levels of leukocyte count,cortisol,C reactive protein,blood glucose at different time points and the incidence of pulmonary infection were observed and compared between the two groups.Results The anesthesia onset time,postoperative recovery time and spontaneous respiration recovery time in compound anesthesia group were shorter than those in general anesthesia group,and the incidence of pulmonary infection was significantly lower than that in general anesthesia group(P<0.05).The white blood cell count,cortisol,C-reactive protein,blood glucose level at T2(10 min after pneumoperitoneum),T3(30 min after pneumoperitoneum),and T4(10 min after pneumoperitoneum were removed)in the compound anesthesia group and the general anesthesia group in comparison,the difference was statistically significant(P<0.05).Conclusion General anesthesia combined with epidural anesthesia can effectively accelerate the postoperative recovery time of patients with laparoscopic cholecystectomy,inhibit the body stress response,and reduce the risk of pulmonary infection.
作者
陈宏
严进军
CHEN Hong;YAN Jinjun(Department of Anesthesiology,FAW General Hospital of Jilin Province,Changchun 130011,China)
出处
《中国医药指南》
2020年第29期109-110,共2页
Guide of China Medicine
关键词
腹腔镜下胆囊切除术
全身麻醉
硬膜外麻醉
肺部感染
应激反应
Laparoscopic cholecystectomy
General anesthesia
Epidural anesthesia
Pulmonary infection
Stress response
