摘要
目的研究全身麻醉、硬膜外麻醉复合应用的作用机制及其在食管癌术中的应用价值。方法将2018年1月至2020年6月于我院行手术治疗的152例食管癌患者随机分成采用单纯全身麻醉干预的Q组(76例)和采用全身麻醉+硬膜外麻醉干预的Q+Y组(76例)。于不同时间点监测Q组和Q+Y组患者的血流动力学指标[心率(HR)、平均动脉压(MAP)],并统计两组患者麻醉药物用量,采用Aldrete评分评价苏醒质量,统计麻醉相关并发症的发生率。结果插管后5 min、拔管后5 min,Q组HR、MAP均高于Q+Y组(P<0.05)。Q+Y组患者麻醉药物用量低于Q组(P<0.05)。Q+Y组患者苏醒时间短于Q组(P<0.05),Aldrete评分高于Q组(P<0.05)。Q+Y组患者苏醒延迟、呼吸道梗阻、心律失常等麻醉相关并发症的总发生率为7.89%,低于Q组(21.05%),P<0.05。结论于食管癌患者手术麻醉中,在全身麻醉的基础上复合应用硬膜外麻醉可有效促进患者血流动力学的稳定,减少麻醉药物用量,并提高患者苏醒质量,降低麻醉相关并发症的发生率。
Objective To study the mechanism of combined application of general anesthesia and epidural anesthesia,and its application value in esophageal cancer surgery.Methods One hundred and fifty-two patients with esophageal cancer who underwent surgical treatment in our hospital from January 2018 to June 2020 were randomly divided into group Q(76 cases)with general anesthesia intervention and group Q+Y(76 cases)with general anesthesia+epidural anesthesia intervention.The hemodynamic indexes[heart rate(HR)and mean arterial pressure(MAP)]of patients in group Q and group Q+Y were monitored at different time points,and the dosage of narcotic drugs was counted.The quality of recovery was evaluated by Aldrete score,and the incidence of anesthesia related complications was counted.Results HR and MAP in group Q were higher than those in group Q+Y 5 min after intubation and 5 min after extubation(P<0.05).The dosage of narcotic drugs in group Q+Y was lower than that in group Q(P<0.05).The recovery time of group Q+Y was shorter than that of group Q(P<0.05),and Aldrete score was higher than that of group Q(P<0.05).The total incidence of anesthesia related complications such as delayed recovery,respiratory tract obstruction and arrhythmia in group Q+Y was 7.89%,which was lower than that in group Q(21.05%)(P<0.05).Conclusion Combined application of epidural anesthesia on the basis of general anesthesia can effectively promote the stability of hemodynamics,reduce the dosage of narcotic drugs,improve the quality of recovery and reduce the incidence of anesthesia related complications.
作者
王付星
候倩
赵鹏
WANG Fuxing;HOU Qian;ZHAO Peng(Department of Anesthesiology,People's Hospital of Qihe County,Qihe 251100,China)
出处
《中国医药指南》
2021年第15期23-25,共3页
Guide of China Medicine
关键词
食管癌
手术麻醉
全身麻醉
硬膜外麻醉
血流动力学
苏醒质量
Esophageal cancer
Surgical anesthesia
General anesthesia
Epidural anesthesia
Hemodynamics
Recovery quality
