三种麻醉方法对妇科腹腔镜手术患者的影响

A contrast research on three different anaesthesias methods in gynecology peritoneoscope surgery

目的三种麻醉方法(腰硬联合加浅全麻、气管内插管、喉罩)对妇科腹腔镜手术患者的影响。方法90例ASA评级Ⅰ-Ⅱ级择期妇科腹腔镜手术患者随机分为3组,每组30例。Ⅰ组采用腰硬联合加浅全麻;Ⅱ组采用气管内插管麻醉;Ⅲ组采用喉罩麻醉。监测PetCO2、HR、SpO2和MAP等血流动力学指标。结果Ⅲ和Ⅱ组比较,在T1、T2、T3时,PetCO2变化有显著性差异(P<0.01),SpO2无明显差异,Ⅰ、Ⅱ和Ⅲ组三者亦无明显差异。在T1、T2时,Ⅲ和Ⅰ组比较,HR,MAP比较有明显差异(P<0.05),Ⅰ、Ⅱ和Ⅲ组三者亦无明显差异。结论腰硬联合加浅全麻在妇科腹腔镜手术中是一种安全有效的麻醉方法。

Objective To discuss the three different anaesthesias methods in gynecology peritoneoscope surgery （Combined Spinal Epidural Analgesi, pure tube-inserting, Larynx Mask）. Method 90 case of patients stochastically divide into the CESA group（ group Ⅰ）, the pure tube-inserting group （group Ⅱ）, and the Larynx Mask group（ group Ⅲ）, Then separatedly monitor and record their PetCO2,HR,SpO2 and MAP. Results After CO2 pneumoperitoneum, HR of the patients in group I speeds up, their PetCO2 elevates obviously （P 〈 0. 01 ） ; the response of the patients in group Ⅱ/Ⅲ becomes active when pneumoperitoneum, the change of MAP,HR is more remarkable than that before pneumopefitoneum （P 〈 0. 01 ）. Each target of the three groups of patients has been improved T1, T2 and T3. after pneumoperitoneum, Each target is quite close to that before pneumoperitoneum T1 and T2 after Exhausting. The consciousness of the patients in group i regains more quickly compared to those in group Ⅱ/Ⅲ after the surgery （P 〈 0. 001 ）. Conclusion The CSEA assisted by the shallow and general vein anesthesia was the effective method in the gynecology perhoneoseope surgery.