硬膜外阻滞复合全麻在胸科肿瘤手术中的应用

目的：比较硬膜外阻滞复合全麻与单纯全麻在胸科肿瘤手术中的临床应用,在麻醉效果、血流动力学、术后苏醒等方面的影响。方法：46例择期胸科肿瘤手术患者（ASAⅠ～Ⅲ）,随机分成两组,Ⅰ组应用硬膜外阻滞复合全麻并行PCEA,Ⅱ组应用单纯全身麻醉。并对术中MAP、HR、SPO2、全麻药用量,术后苏醒程度,拔管时间及术后并发症进行观察。结果：Ⅰ组病例术中血流动力学平稳,围拔管期心血管反应轻微,全麻药用量少,苏醒迅速彻底,术后并发症少。Ⅱ组病例术中血流动力学波动大,围拔管期心血管反应较强,苏醒时间相对较长,术后并发症较多。结论：硬膜外阻滞复合全麻能更有效抑制胸科肿瘤手术的应激反应,保持血流动力学平稳,促进术后呼吸功能的恢复。麻醉效果及安全性优于单纯全麻。

The Application of Epidural Block Combining with General Anesthesia in Chest Surgical Tumor Operation

Objective：To contrast the effect of applying epidural blockade combining with general anesthesia and applying general anesthesia solely in chest surgical tumor operation. Methods： Fourty--six patients（ASA Ⅰ -Ⅲ ）who needed chest surgical tumor operation were grouped into two group random. Epidural blockade combining with general anesthesia was applied in the first group patients and general anesthesia was used solely in the other group. The MAP, HR,SPO2 in operation, general anesthetics, when regained consciousness and complication after operation was observed. Results：The effect of the first group was excellence than the other group. The homodynamic was steady, regained consciousness rapidly and had the complication after operation a little. But the situation in the second group was opposite. Conclusion：The effect of applying epidural blockade combining with general anesthesia was excellence than applying general anesthesia solely in chest surgical tumor operation.