摘要
目的探究与分析腰硬联合麻醉阻滞复合全麻和单纯全麻对腹腔镜直肠癌根治术应激反应的影响。方法选取本院2013年7月至2015年7月收治的80例腹腔镜直肠癌根治术患者，采取随机数字表法分为对照组与观察组，各40例。对照组单纯全麻，观察组腰硬联合阻滞复合全麻。对比两组不同时间点MAP、HR、SpO2、Glu、Gor，术后呼吸恢复时间、拔管时间、苏醒时间及术毕清醒质量，对比两组术后12h血清IL-6、IL-10、TNF—a等炎症因子水平。结果对照组T3时MAP、HR、PetCO2、Glu、Cor与T1时相比均显著升高，差异有统计学意义（t=3．45、4．23、4．92、5．01、8．79，P〈0．05）。对照组T2、T4时MAP、HR、PetCO2、Glu、Cor水平与T1时相比，差异无统计学意义（t=1．21、1．23、1．34、1．21、1．36，P〉0．05；t=1．53、1．42、1．87、1．27、1．31，P〉0．05）。观察组T1、T2、T3、T4时MAP、HR、PetCO2、Glu、Cor水平时点间相比，差异无统计学意义（f=1．54、1．02、1．39、1．22、1．09，P〉0．05；t=1．54、1．65、1．37、1．55、1．67，P〉0．05；t=1．47、1．65、1．38、1．98、1．03，P〉0．05）。T3时，对照组MAP、HR、PetCO2、Glu、Cot均显著高于观察组，差异有统计学意义（t=4．21、4．23、4．34、4．21、436，P〈0，05）。与对照组相比，观察组呼吸恢复时间、拔管时间、苏醒时间均缩短，术毕清醒质量优良率提高，差异有统计学意义（t=3．98、4．21、3．77，x^2=5．61，P〈0．05）。与对照组相比，观察组术后12h血清IL-6、IL-10、TNF—a等炎症因子水平明显较低，差异有统计学意义（t=4．34、4．93、4．18，P〈0．05）。结论采用腰硬联合麻醉阻滞复合全麻相比单纯全麻对腹腔镜直肠癌根治术患者产生的应激反应较小，稳定生命体征，术后恢复快，安全性较高，值得推广应用。
Objective To explore and analyze the influence of combined spinal and epidural anesthesia combined with general anesthesia versus general anesthesia on the stress response of rectal cancer radical operation. Methods 80 patients with laparoscopic colorectal cancer treated at our hospital from July, 2013 to July, 2015 were selected and were divided into a control group and an observation group by random number table, 40 cases for each group. The control group were given only general anesthesia and the observation group combined spinal and epidural anesthesia and general anesthesia. The MAP, HR, SpO2, Glu, Got, postoperative respiratory recovery time, extubation time, and the quality of conscious waking were compared. The serum levels of IL-6, IL-10, CPR and other inflammatory factors 12 hours after operation were compared between these two groups. Results MAP, HR, PetCO2, Glu, and Cor were obviously higher at T3 than T1 in the control group, with statistical differences （ t=-3.45, 4.23, 4.92, 5.01, 8.79, P〈0.05）. There were no statistical differences in MAP, HR, PetCO2, Glu, and Cot between at T1 and at T2 and T4 in the control group （t=-1.21, 1.23, 1.34, 1.21, 1.36, P〉0.05; t=1.53, 1.42, 1.87, 1.27, 1.31,P〉0.05） and between at TI and at T2, T3, and T4 in the observation group （t=-1.54, 1.02, 1.39, 1.22, 1.09, P〉0.05; t=1.54, 1.65, 1.37, 1.55, 1.67,P〉0.05; t=1.47, 1.65, 1.38, 1.98, 1.03,P〉0.05）. At T3, MAP, HR, PetCO2, Glu, and Cor were significantly higher in the control group than in the observation group, with statistical differences （t=-4.21, 4.23, 4.34, 4.21, 4.36, P〉0.05）. The breathing recovery time, extubation time, and time to come to were shorter and the quality of conscious waking was higher in the observation group than in the control group, with statistical differences （t=-3.98, 4.21, 3.77, X 2=5.61, P〉0.05）. The serum levels of IL-6, IL- 10, and other inflammatory markers, such as CPR, 12 hours after operation were significantly lower in the observation group than in the control group, with statistical differences （t=-4.34, 4.93, 4.18, P〈0.05）. Conclusions Combined spinal and epidural anesthesia combined with general anesthesia for laparoscopic colorectal cancer operation has small radical stress response, stable vital signs, and fast postoperative recovery. It is safe and worth being generalized.
出处
《国际医药卫生导报》
2016年第6期756-759,共4页
International Medicine and Health Guidance News
关键词
腰硬联合阻滞复合全麻
单纯全麻
腹腔镜直肠癌根治术
应激反应
Combined spinal and epidural anesthesia
General anesthesia
Laparoscopic colorectal cancer radical
Stress response
