腰硬联合麻醉和持续硬膜外麻醉在子宫肌瘤手术中的效果对比研究

目的：比较腰硬联合麻醉与持续硬膜外麻醉在子宫肌瘤手术中的临床疗效。方法：选择90例行子宫肌瘤切除的患者资料，随机分为观察组和对照组，每组45例。对照组采用硬膜外麻醉方法；观察组采用腰硬联合麻醉方法。术中对患者血压（BP）、心率（HR）和手术牵拉反应进行监测，比较两组患者的麻醉效果和不良反应发生情况。结果：①两组患者在麻醉期间血压均有所降低，观察组患者收缩压和舒张压降低显著，其差异有统计学意义（X2=5．232，X2=6．251；P〈0．05）；②观察组的麻醉起效时间、阻滞完全时间及局麻药的用量与对照组相比差异显著，具有统计学意义（X2=6．278，X2=9．674，X2=12．256；P〈0．05）,③观察组麻醉优良率均高于对照组，两组比较差异有统计学意义（X2=16．576，P〈0．01）。结论：在子宫肌瘤手术中，腰硬联合麻醉较硬膜外阻滞麻醉效果好，是一种值得推广使用的麻醉方法。

Comparative study on combined spinal-epidural anesthesia and combined epidural anesthesia in uterine myomectomy

0bjeetive- To comparative study the clinical effect of combinecl spinal-epidural anesthesia and combined epidural anesthesia in uterine myomectomy. Methods： Totally 90 cases of patients with uterine myomectomy in our hospital from March 2012 to March 2015 were randomly divided into observation group and the control group, 45 patients in the control group were given epidural anesthesia, and observation group were given combined spinal-epiduralanesthesia. BE HR and surgical traction reaction were monitored in the operation and the effects of anesthesia and adverse events of the two groups were compared. Results： （1） Blood pressure of patients in two groups was decreased during anesthesia. Systolic pressure （x2=5.232, P〈0.01） and diastolic blood pressure （x2=6.251, P〈0.05） of patients in observation group were lower than control groups. The difference was statistically significant. （2）Patients of observation group showed shorter anesthesia onset time （x2=6.278, P〈0.05） and completing time （x2=9.674, P〈0.05）, lower local anesthetics dosage （x2= 12.256, P〈0.05）, better evaluation of anesthesia, and fewer adverse reactions. The difference was statistically significant （x2= 16.576, P〈 0.01）. （3）Anesthesia excellent rate in observation group were higher than that of control group, the difference was statistically significant （P〈0.01）. Conclusion： Combined spinal-epidural anesthesia has better anesthesia effects in uterine myomectomy than epidural anesthesia. And it is a worthy use of anesthesia.