不同麻醉方式对开胸患者术后并发症的影响

The Comparision of Complications with Different Anesthesia for Patients undergoing Thoracic Surgery

目的:比较单纯全麻和胸段硬膜外阻滞复合全麻进行开胸手术的术后麻醉相关并发症。方法:40例食管癌根治术患者,随机分为硬膜外复合全麻组(研究组)和单纯全麻组(对照组)。研究组患者确保硬膜外阻滞效果确切。以芬太尼、维库溴铵和七氟醚维持麻醉。术后研究组患者采用硬膜外自控镇痛,对照组患者采用吗啡静脉自控镇痛。记录2组患者的一般资料、麻醉苏醒室(PACU)情况、疼痛视觉模拟评分(VAS评分)、术后麻醉相关并发症、住院天数以及患者满意程度等。结果:2组患者一般资料无显著差异(P>0.05)。与对照组比较,研究组患者PACU停留时间短、相关并发症的发生率低及术后住院天数少(P<0.05),2组患者术后下肢运动阻滞情况和活动能力无显著差异(P>0.05),镇痛效果及患者满意程度研究组明显优于对照组(P<0.05)。结论:胸段硬膜外阻滞复合全麻是更适合开胸手术的麻醉方式。

Objective：To compare the complications of different anesthesia for patients undergoing thoracic surgery. Methods： A total of 40 patients scheduled for esophagectomy were randomly divided into 2 groups, the combined epidural-sevoflurane group（Group E） and general group （Group G）. Patients in Group E underwenl epidural blockade before induction and the epidural blockade was confirmed. The anesthesia was maintained with appropriate concentration of sevoflurane, intermittent fenta nyl and veeuronium, hIS was maintained bewteen 40 and 60. Patients in Group E were received postoperative continuous epidural analgesia while patients in Group G received postoperative continuous intravenous analgesia. The information recorded included the patients＇ epidemiologic characteristics, the information in post anesthesia care unit （PACU）, visual analogue scale （VAS） scores, side effects, the hospital day （HOD） after operation, patients＇ satisfaction scores and so on. Results： There was no difference in general data between the two groups（P〉0. 05 ）. The average bed rest time was also the same（P〉0.05）. The length of stay in PACU, the incidence of complications associated and the HOD after surgeries in Group E were all lower than those in control group（P〈0.05）. Group E was siginificantly better than Group G in postoperative analgesia（P〈0.05）. Overall satisfaction scores were significantly higher in Group E than in Group G （P〈0.05）. Conclusions： Combined thoracic epidural-sevoflurane anesthsia is an effective method for patients undergoing thoracic surgery.