摘要
目的比较蛛网膜下腔阻滞-硬膜外镇痛与全麻-静脉镇痛对行子宫肌瘤手术患者围术期凝血功能的影响。方法选择行开腹子宫肌瘤剔除手术或开腹全子宫切除手术患者60例,随机分为蛛网膜下腔阻滞-硬膜外镇痛组(SA组,n=30)与全麻-静脉镇痛组(GA组,n=30)。分别于麻醉前(T_1)、术毕即刻(T_2)和术后48h(T3)时间点,抽取患者静脉血检测凝血酶原时间(PT)、激活部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(FIB)。结果在全麻-静脉镇痛组,围术期期间T_1、T_2、T3时间点PT、APTT和TT变化差异无统计学意义(P>0.05);在蛛网膜下腔阻滞-硬膜外镇痛组,TT在围术期期间3个时间点无明显变化,PT、APTT在T_1、T_2时间点差异无统计学意义(P>0.05),而在术后T_3时间点与术前比较明显延长(P<0.05);2组患者FIB均在T3时间点明显升高(P<0.05),且GA组明显高于SA组(P<0.05)。结论与全麻-术后静脉镇痛相比,蛛网膜下腔阻滞-硬膜外镇痛可有效预防子宫肌瘤手术患者围术期的高凝状态。
Objective To assess the effect of spinal anesthesia （SA） with postoperative continuous epidural analgesia and general anesthesia （GA） with patient controlled intravenous analgesia on perioperative blood coagulation in patients undergoing surgery for uterine leiomyomas. Methods 60 women with leiomyomas undergoing surgery of myomectomy or hysterectomy were randomized to receive either standard SA or GA technique （n = 30）. Venous blood samples were taken before anesthesia induction,the end of surgery and at 48 h after surgery for testing PT,APTT,TT and FIB. Results The age,ASA physical status,weight and height,or patient characteristics were no sig- nificant differences between the two groups. The PT,APTT and TT were no difference among the three time point in GA group. The PT and APTT were significantly prolonged at 48h after surgery in SA group （ P 〈 0.05 ）. The FIB was increased at 48h after surgery in the two groups,while the increase was obvious in GA group. Conclusion Comparing with general anesthesia with patient controlled intravenous an- algesia, spinal anesthesia with postoperative continuous epidural analgesia could reduce the risk factor of hypercoagulability.
出处
《宁夏医学杂志》
CAS
2016年第11期1000-1002,共3页
Ningxia Medical Journal
关键词
全身麻醉
蛛网膜下腔阻滞
镇痛
凝血功能
General anesthesia
Spinal anesthesia
Analgesia
Blood coagulation
