摘要
【目的】探讨不同复合全麻方法用于腹腔镜阴式手术中对患者血清疼痛及炎症因子的影响。【方法】于两院行腹腔镜阴式手术治疗的74例子宫良性疾病患者,随机分为观察组和对照组,每组37例。对照组采取腰-硬联合麻醉,观察组采取改良骶管阻滞复合全麻。比较两组患者麻醉相关指标、术前和术后5 d血清疼痛因子[多巴胺(DA)、去甲肾上腺素(NE)、5-羟色胺(5-HT)]水平、术前和术后3 d炎症因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)]水平及不良反应发生情况。【结果】观察组患者麻醉起效时间、阻滞完善时间及术后苏醒时间均短于对照组,且差异有统计学意义(P<0.05),两组患者手术持续时间比较,差异无统计学意义(P>0.05)。两组患者术后5 d血清DA、NE、5-HT水平显著高于同组手术前(P<0.05),且观察组患者术后5 d血清DA、NE、5-HT水平显著低于对照组(P<0.05)。两组患者术后3 d血清炎症因子IL-6、CRP、PCT水平显著高于同组手术前(P<0.05),且观察组患者术后3 d血清各炎症因子水平显著低于对照组(P<0.05)。两组患者术中不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】采用腹腔镜阴式手术治疗女性子宫良性疾病,使用改良骶管阻滞复合静脉全麻引起的炎症反应较轻,麻醉起效时间更快、安全性更好。
【Objective】To explore the effects of different combined general anesthesia methods on serum pain and inflammatory factors in laparoscopic vaginal surgery.【Methods】A study was conducted on 74 patients with benign uterine diseases who underwent laparoscopic vaginal surgery in two hospitals were randomly divided into the observation group and the control group,with 37 patients in each group.The control group received combined spinal-epidural anesthesia,while the observation group received improved sacral canal block combined with intravenous general anesthesia.Anesthesia related indicators,levels of serum pain factor indicators[dopamine(DA),norepinephrine(NE),and 5-hydroxytryptamine(5-HT)]before and 5 days after surgery,the levels of inflammatory factors[interleukin-6(IL-6),C-reactive protein(CRP),and Calcitonin(PCT)]before and 3 days after operation,and the adverse reaction rates were compared between the two groups.【Results】The observation group had shorter onset of anesthesia,complete block time,and postoperative recovery time compared to the control group(P<0.05).There was no statistically significant difference in the duration of surgery between the two groups of patients(P>0.05).The postoperative serum levels of DA,NE,and 5-HT on 5 days after operation in the two groups of patients were significantly higher than those in the same group before surgery(P<0.05).The postoperative serum levels of DA,NE,and 5-HT in the observation group were significantly lower than those in the control group(P<0.05).The levels of serum inflammatory factors IL-6,CRP,and PCT in the two groups of patients on 3 days after surgery were significantly higher than those in the same group before surgery(P<0.05),while the levels of serum inflammatory factors in the observation group were significantly lower than those in the control group(P<0.05).There was no statistically significant difference in the incidence of intraoperative adverse reactions between the two groups of patients(P>0.05).【Conclusion】In laparoscopic vaginal surgery for the treatment of benign uterine diseases in women,the use of modified sacral canal block combined with intravenous general anesthesia causes less inflammation,faster onset time,and higher safety in patients.
作者
魏锦莉
李兵
WEI Jin-li;LI Bing(Department of Medical Xi'an New Chang'an Obstetrics and Gynecology Hospital,Xi'an Shaanxi 710000)
出处
《医学临床研究》
CAS
2023年第5期758-760,764,共4页
Journal of Clinical Research
