摘要
目的探讨腰-硬联合麻醉对行腹腔镜胆囊切除术的肥胖患者血流动力学、苏醒时间及不良反应的影响。方法选取2018年1月至2019年10月在本院行腹腔镜胆囊切除术的肥胖患者100例为研究对象,随机分为观察组和对照组,各50例。观察组采用腰-硬联合麻醉,对照组采用硬膜外麻醉。比较两组麻醉后手术过程中血流动力学的变化、术后苏醒时间以及不良反应发生率。结果观察组收缩压、舒张压、心率明显低于对照组(均P<0.05);与T1(术前)比较,对照组和观察组在T2(插管时)、T3(术中)、T4(拔管后)收缩压、舒张压、心率均升高(均P<0.05),但对照组升高幅度较观察组大(均P<0.05)。观察组自主呼吸恢复时间[(4.56±1.23)min比(8.99±3.12)min]、拔管时间[(7.48±2.52)min比(15.41±3.12)min]、完全清醒时间[(15.96±5.55)min比(27.58±5.26)min]均较对照组短(均P<0.05)。观察组不良反应发生率6.0%,对照组30.0%(P<0.05)。结论腰-硬联合麻醉能够减少胆囊切除术对肥胖患者血流动力学的影响,缩短苏醒时间,降低不良反应发生率,提高治疗效果。
Objective To investigate the effects of spinal and epidural anesthesia on hemodynamics,awakening time,and adverse reactions in obese patients undergoing laparoscopic cholecystectomy.Methods 100 obese patients who underwent laparoscopic cholecystectomy at our hospital from January,2018 to October,2019 were selected as the research objects,and randomly divided into an observation group and a control group,with 50 cases in each group.The observation group was given spinal and epidural anesthesia,and the control group epidural anesthesia.The hemodynamic changes,postoperative awakening time,and adverse reactions were compared between the two groups.Results Compared with those of the control group,the systolic blood pressure,diastolic blood pressure,and heart rate of the observation group were significantly lower(all P<0.05).Compared with those at T1(preoperation),the systolic blood pressure,diastolic blood pressure,and heart rate were higher at T2(intubation),T3(intraoperatively),and T4(after extubation)(all P<0.05)in both groups,and were higher in the control group than in the observation group(all P<0.05).The recovery time of spontaneous breathing[(4.56±1.23)min vs.(8.99±3.12)min],extubation time[(7.48±2.52)min vs.(15.41±3.12)min],and completely awake time[(15.96±5.55)min vs.(27.58±5.26)min]were shorter in the observation group than in the control group(all P<0.05).The incidence of adverse reactions was lower in the observation group than in the control group(6.0%vs.30.0%;P<0.05).Conclusion Spinal and epidural anesthesia can reduce the influence of cholecystectomy on the hemodynamics of obese patients,shorten their awakening time,reduce the incidence of adverse reactions,and improve the treatment effect.
作者
谢翼
Xie Yi(Department of Anesthesiology,Zibo Central Hospital,Zibo 255036,China)
出处
《国际医药卫生导报》
2020年第22期3481-3484,共4页
International Medicine and Health Guidance News
关键词
腰-硬联合麻醉
肥胖
腹腔镜胆囊切除术
血流动力学
苏醒时间
不良反应
Spinal and epidural anesthesia
Obesity
Laparoscopic cholecystectomy
Hemodynamics
Awakening time
Adverse reactions
