三种麻醉方法对胃癌根治术应激反应的影响

目的探讨三种不同麻醉方法对胃癌根治术患者应激反应的影响。方法45例择期施行胃癌根治术的患者,随机分为连续硬膜外阻滞组(A组)、单纯全麻组(B组)和全麻复合硬膜外阻滞组(C组),每组15例。分别测定麻醉前、插管、探查和拔管时各时点肾上腺素(E)、去甲肾上腺素(NE)、血糖的浓度,同时记录以上各时点的平均动脉压(MAP)和心率(HR)。结果与麻醉前比较,A、B两组各观察时点血浆激素水平较麻醉前明显升高(P<0.05);与C组相比较,A、B两组各时段血浆激素水平均明显升高(P<0.05);C组术中各时点MAP、HR的变化均较A、B两组轻且平稳(P<0.01),C组与麻醉前比较差异无统计学意义(P>0.05),A、B两组与麻醉前比较差异有统计学意义(P<0.01);三组术中血糖水平均比麻醉前明显升高(P<0.01),各观察时点A、C两组均明显低于B组(P<0.05)。结论全麻复合硬膜外阻滞对比硬膜外阻滞和单纯全麻能较好地抑制胃癌根治术的应激反应。

The effect of three anesthesia methods for stress in gastric carcinoma surgeries

Objective To study the effect of three anesthesia methods for stress in gastric carcinoma surgeries.Methods 45 patients undergoing gastric carcinoma surgeries were randomly divided into three groups(n=15): Continuous epidural block(Group A),Simple general anesthesia(Group B),Combined general-epidural anesthesia(Group C).the level of epinephrine,norepinephrine and blood sugar were detected before anesthesia,cannula,exploration and extubation durations respectively.MAP,HR were recorded at the same time.Results The level of plasm hormone before anesthesia in group A and group B was higher than other period(P<0.05).Comparing with group C,the level of plasm hormone in group A and group B was higher in every period(P<0.05).The changes of MAP,HR were steady in group C than group A and group B during the operation(P<0.01),there was no difference before anesthesia in group C(P>0.05),while there was significant differences in group A and group B(P<0.01).The level of blood sugar in every period increased in every group(P<0.01),while the level of groupA and group C was lower than group B(P<0.05).Conclusion stress can be reduced by Combined general epidural anesthesia better in gastric carcinoma surgeries.