摘要
目的探讨分析全身麻醉(全麻)联合硬膜外麻醉对老年腹腔镜妇科手术患者胃肠道功能、应激反应及神经功能的影响。方法选取48例老年腹腔镜妇科手术患者,采用随机数字表法将患者分为联合组与全麻组,每组24例。联合组患者行全麻联合硬膜外麻醉手术,全麻组患者行全麻手术,比较两组患者术前、术后应激反应、神经功能及胃肠道功能指标。结果术前,两组患者C反应蛋白、皮质醇、血糖指标比较,差异无统计学意义(P>0.05);与术前比较,两组患者术后C反应蛋白、血糖水平明显升高,且全麻组上升幅度比联合组更大,差异有统计学意义(P<0.05);全麻组术后皮质醇水平有所升高,且其术后皮质醇水平显著高于联合组,差异有统计学意义(P<0.05)。术前,两组患者人S100B蛋白、神经元特异性烯醇化酶、血髓鞘碱性蛋白指标比较,差异无统计学意义(P>0.05);与术前比较,两组术后人S100B蛋白、神经元特异性烯醇化酶、血髓鞘碱性蛋白指标均明显升高,且全麻组人S100B蛋白、神经元特异性烯醇化酶、血髓鞘碱性蛋白指标明显高于联合组,差异有统计学意义(P<0.05)。术前,两组患者饥饿素、胃泌素、胃动素指标比较,差异无统计学意义(P>0.05);与术前比较,两组患者术后饥饿素、胃泌素、胃动素指标明显下降,且全麻组下降幅度比联合组更大,差异有统计学意义(P<0.05)。结论与对老年腹腔镜妇科手术患者行单独全麻相比,硬膜外麻醉联合全麻可以有效缓解机体应激反应,降低手术对患者神经功能与胃肠道功能造成的不良影响。
Objective To analyze the effects of general anesthesia combined with epidural anesthesia on gastrointestinal function,stress response and neurological function in elderly patients undergoing laparoscopic gynecological surgery.Methods A total of 48 elderly patients undergoing laparoscopic gynecological surgery were selected and divided into combined group and general anesthesia group by random number table method,with 24 cases in each group.Patients in the combination group received general anesthesia combined with epidural anesthesia,and patients in the general anesthesia group received general anesthesia.The indexes of stress response,neurological function and gastrointestinal function before and after surgery were compared between the two groups.Results Before surgery,there were no significant differences in C-reactive protein,cortisol and blood glucose indexes between two groups(P>0.05).Compared with preoperative,postoperative C-reactive protein and blood glucose levels in two groups were significantly increased,and the increase rate in the general anesthesia group was greater than that in the combined group,with statistical significance(P<0.05).Postoperative cortisol level in the general anesthesia group was increased,and the postoperative cortisol level was significantly higher than that in the combined group,with statistical significance(P<0.05).Before surgery,there were no significant differences in human S100B protein,neuron-specific enolase and blood myelin basic protein indexes between two groups(P>0.05).Compared with preoperation,the indexes of human S100B protein,neuron-specific enolase and blood myelin basic protein were significantly increased in the two groups after surgery,and the indexes of human S100B protein,neuron-specific enolase and blood myelin basic protein in the general anesthesia group were significantly higher than those in the combined group,with statistical significance(P<0.05).Before surgery,there was no statistical significance in the indexes of ghrelin,gastrin and motilin between
作者
梁秀兰
Liang Xiulan(Anesthesia Surgery Center,Jiangmen Central Hospital,Jiangmen 529030,China)
出处
《实用妇科内分泌电子杂志》
2021年第7期5-8,共4页
Electronic Journal of Practical Gynecological Endocrinology
关键词
腹腔镜手术
妇科
全身麻醉
硬膜外麻醉
Laparoscopic surgery
Department of gynaecology.General anesthesia
Epidural anesthesia
