腹腔镜下嗜铬细胞瘤切除术的麻醉方法探讨

Exploration of Anesthetic Way of Laparoscopic Adrenalectomy for Pheochromocytoma

目的探讨适合腹腔镜肾上腺嗜铬细胞瘤切除手术的麻醉方法。方法 24例腹腔镜嗜铬细胞瘤切除手术患者,随机分为两组:全麻组(A组)和全麻+硬膜外组(B组),每组12例。观察2组患者术中血流动力学变化和并发症的发生率。结果两组患者在肿瘤切除前后均出现明显的血流动力学变化,但B组血压、心率波动明显小于A组(P<0.05),麻醉清醒及拨管时间、并发症的发生率均明显少于A组(P<0.05)。结论全麻+硬膜外阻滞应用于腹腔镜嗜铬细胞瘤切除手术麻醉,术中血流动力学波动范围小,并发症少,是一种较好的麻醉方法 。

Objective To investigate the anesthetic way of laparoscopic adrenalectomy for pheochromocytom.Methods Twenty-four patients were divided randomly into two groups with 12 in each group.Group A underwent laparoscopic adrenalectomy for pheochromocytom under general anesthesia,while group B received the operation under general anesthesia combined with extradural anesthesia.Among all the patients,hemodynamic changes and the complication rate were observed.Results During the whole surgery,distintive hemodynamic changes were present in both groups,but the fluctuation of blood pressure and heart rate in group B were apparently lower than those in group A（P0.05）.Besides,compared with group A,not only it take less time for the patients of group B to become conscious after anesthesia,but also time of decamnidation was shorten,with lower complication rate.Conclusion The application of general anesthesia combined with extradural anesthesia in laparoscopic adrenalectomy for pheochromocytom is a better choice with lower hemodynamic changes and complication rate.