腹腔镜辅助手术麻醉在高龄患者中的临床价值与安全性研究

Clinical value and safety study of laparoscopic assisted surgery anesthesia in very elderly patients

目的研究高龄患者应用腹腔镜辅助手术麻醉的临床价值与安全性。方法选择本院2011年11月～2012年11月高龄腹腔镜辅助手术患者36例作为观察组,同时选择同期老年腹腔镜辅助手术患者36例作为对照组,所有患者均采用全身麻醉复合静吸麻醉,对两组患者手术成功率及不良反应进行比较。结果观察组与对照组患者手术均获得成功,两组平均手术时间、平均苏醒时间与平均住院时间比较,差异无统计学意义(P>0.05)。观察组出现1例因陈旧脑梗死出现新脑梗死病灶,转入神经内科保守治疗,其余患者未出现与麻醉相关的并发症。结论高龄患者通过麻醉前评估,控制合并症,积极预防并发症,多科室协作严格围手术麻醉期管理,可安全度过围手术麻醉期。

Objective To investigate the clinical value and safety of laparoscopic assisted surgery anesthesia in very elderly patients. Methods Thirty-six cases of very elderly patients who were given laparoscopic assisted surgery in our hospital from November 2011 to November 2012 were selected as observation group. And 36 cases of elderly patients who were given laparoscopic assisted surgery at the same time were selected as control group. General anesthesia associated with inhalation anesthesia was taken for all patients. And, the success rates of surgery and untoward effects of two groups were compared. Results All surgery in 72 patients of both groups were successful. The differences in average operation time, mean awakening time and average hospital stays between two groups were not statistically significant （P 〉 0.05）. 1 case of observation group was transferred to Department of Neurology for conservative treatment because new cerebral infarction lesion appeared resulting from old cerebral infarction lesion. Other patients did not have complications in relation to anesthesia. Conclusion Very elderly patients can undergo perioperative period of anesthe- sia safely by means of pre-anesthetic evaluation, positive prevention and control of complications, multi-department cooperation in perioperative period of anesthesia.