不同麻醉方法对胆道手术病人心血管反应的影响

目的:探讨硬膜外麻醉、全麻、硬膜外复合全麻对胆道手术病人心血管反应的影响。方法:择期胆道手术70例,ASAⅠ~Ⅱ级,随机分成3组,即硬膜外组(E组n=30),全麻组(T组,n=20),硬膜外复合全麻组(E+T组,n=20),监测并记录麻醉过程中的HR、MAPs、PO2的变化。结果:E组:麻醉后20min,HR、MAP明显下降,与麻醉前相比有显著性差异(P<0.05)。T组:麻醉后各时间点上HR、MAP显著性升高,有显著性差异(P<0.05)。E+T组:麻醉前后,HR、MAP平稳,无显著性差异(P>0.05)。组间:MAP、HR,T组与E、E+T组相比有显著性差异(P<0.05)。sPO2,E组与T组、E+T组相比有显著性差异(P<0.05)。结论:硬膜外复合全麻麻醉前后血流动力学稳定,更适合于胆道手术麻醉。

The Effects of Different Anaesthesia Technic on Cardiovascular Reaction during Biliary Tract Surgery

Objective: To study the effects of epidural anaesthesia,general anaesthesia and combined anaesthesia on cardiovascular reaction during biliary tract surgery.Methods: Seventy adult patients(ASA Ⅰ～Ⅱ) scheduled for elective biliary tract surgery were divided randomly into block group(E,n=30),general anaesthesia group(T,n=30) and combined group(E+T,n=20),HR,MAP,sPO_2 were recorded during operation.Results: After anaesthesia,in group E the levels of HR,MAP were decreased more markedly in 20 min than that before anaesthesia(P<0.05).In group T the levels of HR,MAP,were increased more significantly than that before anaesthesia(P<0.05).In group E+T the levels of HR,MAP were kept steadily(P>0.05).The levels of HR,MAP in group T were significantly than that in other two groups(P<0.05).sPO_2 in group E was more significant than that in other two groups(P<0.05().)Conclusion: Cardiovascular reaction in combined group was kept steadily during operation.