摘要
目的 观察全身麻醉复合硬膜外腔阻滞麻醉用于慢性阻塞性肺疾病（COPD）患者手术的临床效果.方法 选取262例合并COPD需行胸腹部外科和泌尿外科等手术的患者,按时间顺序将患者分为对照组和观察组各131例,分别行单纯全身麻醉和全身麻醉复合硬膜外腔阻滞麻醉,对比观察两组患者手术时间、术后拔管时间、苏醒时间和镇痛效果（VAS评分）等麻醉情况,测定患者用力肺活量（FVC）、第一秒最大呼气率（FEV1/FVC）和用力呼气中段流速（FEF25％～27％）等肺功能指标,对两种麻醉方法的临床效果及并发症发生率进行研究.结果 观察组患者拔管时间、苏醒时间及VAS评分均明显低于对照组（均P＜0.05）.术后观察组患者用力肺活量（FVC）、第一秒最大呼气率（FEV1/FVC）和用力呼气中段流速（FEF25％～27％）等肺功能指标检测结果明显优于对照组患者（均P ＜0.05）.对照组患者麻醉的总有效率为87.0％,观察组患者麻醉的总有效率为96.9％,观察组麻醉的临床效果优于对照组（P＜0.05）.两组患者的手术时间和术后并发症发生率差异无统计学意义（P＞0.05）.结论 全身麻复合硬膜外腔阻滞麻醉应用于COPD患者手术可有效提高麻醉的临床效果,加强了麻醉的安全性,利于患者术后的康复,值得在临床上推广.
Objective To observation the clinical effect of anesthesia combined with epidural block for pa- tients with COPD surgery. Methods 262 cases with COPD needed to line the chest and abdominal surgery and urolo- gy surgery patients. Patients were divided into control group and observation group according to the time sequence, un- derwent general anesthesia and anesthesia combined with epidural anesthesia, contrast observed in patients with opera- tive time, postoperative extubation time, wake time and the analgesic effect of anesthesia （VAS score） was measured in patients with FVC, FEV1/FVC and FEF25 % to 27% lung function, clinical efficacy and complication rate of two an- esthesia methods. Results The patients extubation time,recovery time and VAS scores were significantly lower than those of control group, the differences were statistically significant（ all P 〈 0.05 ）. Group of postoperative patients with FVC, FEV1/FVC and FEF25% to 27%, such as lung function test results were significantly better than those of con- trol group, and the difference was statistically significant（ all P 〈 O. 05 ）. Anesthesia control group total effective rate of 87.0% observed in patients anesthesia total effective rate was 96.9%. Compared with the control group,the anesthe- sia clinical effect of the observation group was statistically significant （ P 〈 0. 05 ）. Operative time and postoperative complication rate of the two groups of patients showed no significant difference（ P 〉 0.05 ）. Conclusion Anesthesia combined with epidural anesthesia used in surgery in patients with COPD can effectively improve the clinical effects of anesthesia,to enhance the safety of anesthesia, which will help the rehabilitation of patients and worth of clinical practice.
出处
《中国基层医药》
CAS
2013年第19期2905-2907,共3页
Chinese Journal of Primary Medicine and Pharmacy
关键词
麻醉
全身
麻醉
硬膜外
肺疾病
慢性阻塞性
Anesthesia, general
Anesthesia, epidural
Pulmonary disease, chronic obstructive
