不同麻醉方式在腹腔镜子宫切除术中的效果分析

目的:探讨硬膜外联合静脉全麻在腹腔镜子宫切除术的临床疗效。方法:收集本院2014年1月-2016年12月行腹腔镜子宫切除术的患者80例临床资料,根据采取的不同麻醉方法分为观察组(硬膜外麻联合全麻)和对照组(静脉全麻)各40例,对比分析两组患者的麻醉效果、术后气管拔管时间、自主呼吸恢复时间、清醒时间、术后躁动、恶心、呕吐、手术时间、住院总费用及追加镇痛药物情况。结果:观察组的麻醉效果总有效率(97.5%)高于对照组(80%)(P0.05);术后气管拔管时间、自主呼吸时间、清醒时间明显更短,术后躁动发生率及术后追加镇痛药物使用率等观察组低于对照组(P0.05);手术时间、住院费用及不良反应发生率两组无差异(P0.05)。结论:硬膜外复合静脉全麻在腹腔镜子宫切除术的术中麻醉效果优于单纯静脉全麻,未增加手术不良反应及住院总费用,值得临床推广应用。

Clinical effect analysis of different anesthesia methods used for laparoscopic hysterectomy

Objective:To explore the clinical effect of epidural combined intravenous anesthesia in laparoscopic hyster ectomy.Methods:The data of 80 patients who experienced laparoscopic hysterectomy in Xuancheng people's hospital from January 2014 to December 2016 were collected.According to the different anesthesia methods,patients were divided into the observation group and the control group,40 cases in the observation group were given epidural anesthesia combined with general anesthesia,and 40 cases in the control group were given intravenous anesthesia.The anesthesia effect,postoperative extubation time,spontaneous breathing recovery time,awake time,rate of postoperative agitation,nausea and vomiting,operation time,total hospitalization expenses and the rate of postoperative additional analgesic drugs of patients in the two groups were compared.Results:Compared to the control group,the total effective rate of patients in the observation group was significantly higher (97.5 ％ vs.80 ％),and the difference had statistically significant (P＜0.05).Furthermore,the tracheal extubation time,spontaneous breathing time,and awake time of patients in the observation group were significant shorter than those of patients in the control group (P＜0.05),and the incidence of postoperative agitation and the additional analgesic drugs rate of postoperative additional analgesic drugs analgesia were significantly lower than those of patients in the control group (P＜0.05).However,the operation time,hospitalization expenses and incidence of adverse reactions of patients had no significantly different between the two groups (P＞0.05).Conclusion:The effect of epidural combined intravenous general anesthesia used for laparoscopic hysterectomy is better than intravenous anesthesia alone,and it does not increase the rate of adverse effects of surgery and the total cost of hospitalization,so it is worthy of clinical application.