全麻与全麻联合硬膜外阻滞对食道中段癌手术应激反应抑制的比较

Comparison Analysis of Stress Reaction Suppression in Middle Esophageal Cancer Operation by General Anesthesia and Combined General Epidural Anesthesia

目的：探讨食道癌中段手术时，全麻与全麻联合硬膜外阻滞两种方法对手术应激反应的抑制效果。方法：选择40例ASAI-Ⅱ级，45-65岁。择期食道癌中段手术病人，随机其中20例采用单纯静脉全麻（G组），其它20例再加用硬膜外阻滞联合麻醉（GE组）。分别监测麻醉诱导前（T0）、麻醉诱导插管后（T1）、切皮后（T2）、手术探查后（T3）、术毕拔管后（T4）的SBP、DBP、MAP、HR以及血糖（BG）血浆去甲基肾上腺素（NE）浓度。结果T2、T3、SBP、DBP、MAP及NE两组有显著性差异；T4：SBP、BG和NE有显著性差异（P〈0．05或0．01）。结论食道中段癌手术时选用全麻和硬膜外阻滞联合麻醉能较好抑制手术中的应激反应。

Objective： To investigate the effect of stress reaction suppression in middle esophageal cancer surgery by general anesthesia and combined general epidural anesthesia. Method：40 patients 45 - 65 years old （ ASA grade Ⅰ-Ⅱ） were divided into two groups randomly. Group G： general anesthesia. Group GE ： combined general epidural anesthesia. SBP, DBP, MAP, HR, BG and NE of each patient were recorded in after intubation （T1）, after cutting （T2）, after exploration （T3） and after extubation （T4）. Result： SBP, DBP, MAP and NE of group GE were better than those of group G in T2 , T3 , SBP, BG and NE of group GE were better than those of group G in T4 also（ P 〈 0.05 or P 〈 0.01 ）. Conclusion ： Stress reaction in middle esophageal cancer operation can be more suppressed by combined general epidural anesthesia.