腹腔镜子宫切除术应用全麻复合硬膜外麻醉对患者应激反应及纤溶功能的影响

目的探讨全麻复合硬膜外麻醉对腹腔镜下子宫切除术患者应激反应及纤溶功能的影响。方法110例择期行腹腔镜下子宫切除术的患者随机分为A、B两组，A组采用全麻复合硬膜外麻醉，B组采用单纯全麻。结果两组麻醉5min的AD、NA及血糖水平较麻醉前下降，术毕则显著升高，术毕及术后24hB组的AD、NA及血糖水平均显著高于A组（P〈0．05）。两组不同时点的各组DD、PAI-1及t—PA水平之间差异有统计学意义（P〈0．05），麻醉5min、术毕及术后24hB组的DD、PAI-1及t—PA水平均显著高于A组（P〈0．01）。结论全麻复合硬膜外麻醉更有效地抑制腹腔镜下子宫切除术患者的应激反应及纤溶亢进，有利于降低并发症的发生，是较为理想的腹腔镜手术麻醉方法。

Effects of stress response and fibrinolytic function on laparoscopic hysterectomy with general anesthesia combined with epidural anesthesia

Objective To investigate the effects of stress response and fibrinolytic function on laparoscopic hysterectomy with general anesthesia combined with epidural anesthesia.Methods A total of 110 cases of undergoing laparoscopic hysterectomy were randomLy divided into A and B group,A group with general anesthesia combined with epidural anesthesia,B group with general anesthesia.Results The AD,NA and blood glucose levels of two groups in anesthesia 5 min were decreased,postoperative were significantly increased.AD,NA,and blood glucose of B group in postoperative and after 24 h were significantly higher than A group(P < 0.05).The DD,PAI-1 and t-PA of two groups had significantly signinificance,the DD and PAI-1 and t-PA of B group in anesthesia 5 min,postoperative and after 24 h were significantly higher A group(P < 0.01).Conclusion General anesthesia combined with epidural anesthesia is more effective to inhibit the stress response and hyperfibrinolysis in patients with laparoscopic hysterectomy,help to reduce the incidence of complications,is an ideal laparoscopic surgical anesthesia.