不同麻醉方法对腹腔镜手术病人的影响

目的：观察腹腔镜手术中不同麻醉方式对病人的影响。方法：125例因各种原因行腹腔镜手术患者，随机分为全身麻醉组（A组）和硬膜外麻醉组（B组）。监测气腹时血流动力学、呼吸、循环和应澈反应相应指标的变化。结果：血流动力学变化：A组和B组的病人气腹形成后HR、SBp、DBp均有上升，并持续于气腹的仝过程，术后渐恢复至气腹前水平，与B组相比，A组升高的幅度较小（P〈0．05）；平均动脉压（MAP）与气腹前比较差异无显著性（P〉0．05）；呼吸、循环变化：气腹前后，A组和B组的病人气腹后呼气末二氧化碳分压（PETCO2）有较明显的上升，术后渐恢复至气腹前水平，两者之间比较差异无显著性，氧饱和度（SpO2）和呼吸频率（RR）气腹后也有上升，但两组比较P〉0．05；应激反应：气腹时B组血浆NE、E浓度均明显增N（P〈0．05），A组无明显变化（P〉0．05）。结论：腹腔镜手术中不同麻醉方式气腹形成时对病人机体的血流动力学，呼吸循环和应激反应均有不同程度的影响。两种麻醉方法比较，全麻对病人机体影响较小。

Effect of different anesthetic methods on the patients in alparoscopic surgery

Obiective:To observe the effect of different anesthetic methods on the patients in laparoscopic surgery.Methods:125 patients because of different reasons for laparoscopic surgery were randomly divided into general anesthesia group (grouPA) and epidural anesthesia group (group B).Haemodynamice,respiration,circulation and stress reaction were monitored during operation.Results:In this reg arnd of hemodynamic change,all the indexes of heart rate (HR),systemic blood pressure (SBp) and diastolic blood pressure (DBp) increased during the period of pneumoperitoneum in two groups and returned to normal level after operation;the difference of range in the group B was much significant compared to that in the group A (P<0.05),but without difference in the average artery pressure (MAp) compared to that before pneumoperitoneum (P>0.05).In this regard of respiration and cirulation,the indexes of carbon dioxide pressure (PETCO2),saturated degree (SPDO2) and respiratory rate (RR) increased obviously during the period of pneumoperitoneum in two groups and returned to normal level after operation,there was no difference between two groups(P>0.05).In this regard of stress reaction:the concentrations of plasma E and NE increased obviously in group B(P<0.05),but without change in group A(P>0.05).Conclusion:Different kinds of methods of anesthesia have a certain effect on the indexes of haemodynamice,respiration,circulation and stress reaction in laparoscopic surgery.General anesthesia has fewer effect compared to the epidural anesthesin.