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为探究腹腔镜下结肠癌根治手术应用全麻联合硬膜外阻滞麻醉的效果以及对患者血流动力学、简明精神状态量表(MMSE)评分的影响,本研究选取98例实施腹腔镜下结肠癌根治手术患者作为研究样本,样本收集时间2014年1月至2016年12月。根据患者所采取的麻醉方法分为联合组、对照组各49例,联合组采用全麻联合硬膜外阻滞麻醉,对照组采用全身麻醉,患者手术结束后,对比两组患者血流动学波动、术后不同时间点的MMSE评分。研究结果显示,T0时刻,联合组和对照组的MAP、HR、SpO2检测值差异无统计学意义(p>0.05);在T1、T2、T3时刻,联合组患者的MAP、HR均显著的高于对照组(p<0.05);两组患者的MAP、HR在T1、T2、T3时刻较本组T0时刻均显著的降低(p<0.05);联合组和对照组的自主呼吸恢复时间、苏醒时间、拔管时间比较,差异均无统计学意义(p>0.05);联合组的丙泊酚用量、瑞芬太尼用量均显著的低于对照组(p<0.05);术前及术后第7天,两组患者的MMSE评分差异无统计学意义(p>0.05);术后1 d、术后3 d,联合组MMSE评分显著的高于对照组(p<0.05);联合组和对照组的MMSE评分较本组术前均显著的降低(p<0.05)。研究结果表明,相比单纯全麻,腹腔镜下结肠癌根治手术患者应用硬膜外阻滞麻醉联合全麻对患者的血流动力学影响更小、麻醉效果好、术后对患者认知功能影响小。
Abstract：To investigate the effect of general anesthesia combined with epidural block anesthesia on laparoscopic radical surgery for colon cancer and its influence on hemodynamic and Mini-Mental State Examination(MMSE)score, in this study, 98 patients who underwent laparoscopic radical surgery of colon cancer were selected as study samples. The collection time of samples was from January 2014 to December 2016. According to the anesthesia methods taken by patients, they were divided into combined group and control group with 49 cases in each group.The combined group used the general anesthesia combined with epidural block anesthesia, and the control group used general anesthesia. After the operation, we compared blood pharmacokinetic fluctuation and postoperative the MMSE score at different time points of patients between two groups. The results indicated that at T0 time,MAP, HR and SpO2 values between combined group and control group had no statistically significant difference(p>0.05); At the time of T1, T2, and T3, MAP, HR in the combined group were significantly higher than those in the control group(p<0.05); The MAP and HR of patients in the two groups decreased significantly at T1, T2 and T3 time compared with the T0 time of the groups(p<0.05); There was no statistically significant difference in the recovery time of spontaneous breathing, wake-up time, and extubation time between the combined group and the control group(p >0.05); The dosage of propofol and remifentanil dosage in the combined group were significantly lower than those in the control group(p <0.05); 7 days before and after operation, there was no statistically significant differences in MMSE scores of patients between two groups(p>0.05); 1 days and 3 days after operation, MMSE scores of combined group was significantly higher than those of control group(p<0.05);The MMSE scores of the combined group and control group were significantly lower than those of the groups before operation(p <0.05). The results showed that compared with general anesthesia alone, general anesthesia combined with epidural block anesthesia had less influence on hemodynamics, better effect on anesthesia, and less influence on postoperative cognitive function in patients undergoing laparoscopic radical colon cancer surgery.
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基本信息:
DOI：10.13417/j.gab.037.005582
中图分类号:R735.35
引用信息:
[1]张兴滨.腹腔镜结肠癌手术全麻联合硬膜外阻滞麻醉的效果评价[J].基因组学与应用生物学,2018,37(12):5582-5588.DOI:10.13417/j.gab.037.005582.
基金信息:
湖北省兴山县人民医院资助
2018-12-25
2018-12-25