静脉麻醉和局部麻醉在乳腺区段手术中的临床比较

Clinical comparison between intravenous anesthesia and local infiltration anesthesia in segmental mastectomy

目的:比较静脉麻醉(IVA)和局部麻醉(LIA)在乳腺区段手术中的效果。方法:收集甘肃省肿瘤医院2004年1月～2009年6月间1029例IVA和627例LIA行乳腺区段切除术的病例,比较两种麻醉方式的镇痛效果、术后感受、不良反应发生率。结果:麻醉后两组MAP均有不同程度升高,但IVA组MAP升高更为显著(P<0.05)。在切皮和分离肿瘤时,LIA组心率高于IVA组(P均<0.05)。IVA组具有较好的镇痛效果和术后满意度(P均<0.05)。LIA组术后恶心、呕吐发生率明显少于IVA组(P<0.05)。结论:IVA是一种较为理想的乳腺区段手术麻醉方法。

Objective：To compare the effect of intravenous anesthesia （IVA） and local infiltration anesthesia （LIA） in segmental mastectomy. Methods：Patients＇ analgesic effect,feeling of post-operation and adverse reaction rate were retrospectively analysed in 1029 cases of IVA and 627 cases of LIA in segmental mastectomy from January 2004 to June 2009 in the Tumor Hospital of Gansu province. Results：After anesthesia,the MAP of both groups were increased in different degrees,but the level of IVA group were significantly higher than that of LIA group（P0.05 ）The HR of LIA group were significantly higher than that of IVA group at the time point of incising skin and separating tumor（P0.05）. IVA group had a better analgesic effect and satisfaction of post-operation than LIA group（P0.05）. The adverse reactions such as nausea,vomiting in LIA group were obviously lower than those of IVA group（P0.05）. Conclusion：IVA is ideal for segmental mastectomy.