腹腔镜下直肠癌手术的不同麻醉处理效果分析

腹腔镜下直肠癌手术的不同麻醉处理效 果分析 崔光荣张果 四川省阊中市人民医院 摘要 目的探讨腹腔镜下直肠癌手术的不同麻醉处理的效果。方法 选取直肠癌患者 66例，全部采用腹腔镜下直肠癌手术。按照入院时间的顺序，将患者随机分为 硬膜外麻醉组、全身麻醉组以及硬膜外麻醉组与全身麻醉混合组，每组22例。 观察3组患者的气腹时间、手术时间以及苏醒时间，同时记录在术中气腹后10 min和气腹后60 min的舒张压、收缩压、心率数据，以及术后发生恶心、肌肉 松弛、躁动等不良反应症状。结果混合组的苏醒时间短于硬膜外麻醉组与全身 麻醉组，且差异具有统计学意义P0. 05;气腹10 min后以及60 min后混合 组的舒张压与收缩压均明显低于全身麻醉组与硬膜外麻醉组，且比较差异具有 统计学意义P0. 05 o手术后24 h内，混合组在肌肉松弛、躁动与恶心呕吐 方面的不良并发症发生率均低于硬膜外麻醉组与全身麻醉组，且差异具有统计 学意义P〈0. 05 o结论对于行腹腔镜下直肠癌手术的患者，采用全身与硬膜 外混合麻醉的方式，能够使患者及时苏醒，在术中保持舒张压、收缩压、心率等 指标的平稳，降低不良反应及并发症的发生率，是一种安全有效地麻醉方式， 值得推广应用。 关键词 腹腔镜;直肠癌;麻醉; 收稿日期2016-10-09 Efficacy of Different Anesthesia in the Laparoscopic Rectal Cancer Surgery Treatment CUI Guangrong ZHANG Guo Langzhong Peoples Hospital Abstract Objective To analyze the effect of different anesthesia in the colorectal surgery treatment. s 66 patients with rectal cancer were selected. And all patients adopt laparoscopic rectal cancer surgery. In accordance with the order of the hospitalized time, patients were randomly divided into the epidural anesthesia group, general anesthesia and epidural anesthesia group mixed with general anesthesia group, each group with 22 patients. Pneumoperitoneum time, operation time and wake up of time, at the same time recorded diastolic and systolic blood pressure, heart rate data in intraoperative pneumoperitoneum afterlO minutes and 60 minutes after pneumoperitoneum, and recorded postoperative adverse symptoms such as nausea, muscle relaxation, restless were observed. Results The awaken time of the mixed was shorter than epidural anesthesia and general anesthesia group, and the difference was statistically significant P 0. 05 ; Pneumoperitoneum in 10 minutes and 60 minutes, the diastolic and systolic blood pressure of the mixed group were significantly lower than the general anesthesia and epidural anesthesia group, and the differences was statistically significant P 0. 05 ; Within 24 h after the surgery, the adverse complications of mixed group in terms of muscle relaxation, restlessness and nausea and vomiting was lower than epidural anesthesia and general anesthesia group, and the difference was statistically significant P 0. 05 . Conclusion For the patients with laparoscopic colorectal cancer surgery, adopt the of whole body mixed with epidural anesthesia, can make patients wake up in time, can make patients in intraoperative diastolic and systolic blood pressure, heart rate and other indicators of smooth and reduce the incidence of adverse symptoms of complications, it is a safe and effective anesthesia way, and it is worthy of popularization and application. Keyword Laparoscopic; Rectal cancer; Anesthesia; Received 2016-10-09 目前，直肠癌是恶性肿瘤中发病率排名前三的疾病，严重影响人们的生活水平 旦1。为了根治直肠癌，常常采用腹腔镜手术进行治疗，但是这种手术中麻醉过 程常常进行长时间二氧化碳气腹，以及伴随心、肺功能下降，恶心呕吐、肌肉松 弛与躁动等不良反应槎1。因此选择最适合的麻醉方式，对于降低不良反应、提 高手术成功率，具有重要的意义。本文探讨腹腔镜下直肠癌手术的不同麻醉处理 方法以及分析其处理效果。 1资料与方法 1.1 一般资料 选取我院2013年5月至2016年4月期间接收诊治的直肠癌患者66例，均采用 腹腔镜下直肠癌手术。按照入院时间的顺序，将患者随机分为硬膜外麻