同种异体肾移植手术2种麻醉方法的效果比较

目的　比较同种异体肾移植手术椎管内阻滞和静吸复合全麻的优缺点。方法　回顾性分析 2 0 0 3年 1— 8月我院器官移植中心所做的同种异体肾移植手术的麻醉 ,对符合条件的 38例患者进行比较。结果　 2组间比较ASA分级 ,术中输液量 ,移植肾血流开放前收缩压、舒张压、心率、麻醉并发症 (仅包括硬膜外血肿或心功能衰竭 )和移植肾存活率无显著性差异 ,体质量和ICU停留时间有显著性差异 ,静吸复合全麻组比椎管内阻滞组体质量更重 ,ICU停留时间更长。结论　椎管内阻滞有时不能满足手术要求 ,能满足手术要求的椎管内阻滞 ,手术结束后循环功能较稳定 ,烦躁不安少见 ,手术后恢复较快 ;静吸复合全麻能更好地满足手术要求 ,尤其是体质量较大的患者 ,但在拔出气管导管前后可能引起血流动力学剧烈波动 ,甚至心功能衰竭 ,手术后恢复较慢

Comparison of two anaesthesia methods for homogeneity variant renal transplantation

Objective It is to compare the advantage and disadvantage between block inside vertebral canal and general mulriple anaesthesia for homogeneity variant renal transplantation.Methods 38 cases of anaesthesia for homogeneity variant renal transplantation from January to August in 2003 in our organ transplantation center were retrospectively analyzed, which were chosen according to the criteria.Results No significant difference was found among ASA status, the amount of intraoperative fluid infusion, systolic and diastolic pressure, heart rate, anaesthesia complications (only including epidural haematoma or heart failure) and the survival rate of the transplanted kidney in the two groups. There was significant difference between body weight and duration of ICU stay in the two groups. In the general mulriple anaesthesia group, the body weight was more weighty and duration of ICU stay was longer than those in the block inside vertebral canal group.Conclusion Block inside vertebral canal can not satisfy operation require occasionally. After the operation finishing, circulation function is jarlesser, dysphoria appears singularly and comeback is quicker in the patients with block inside vertebral canal which can satisfy operation require. General mulriple anaesthesia can better satisfy operation require, especially the patients whose weights are more heavy. But before and after endotracheal tube drew, hemodynamics undulating tempestuously maybe caused, so much as heart failure. And the comeback is slower.