不同麻醉方法用于乳腺癌根治术临床观察

The Clinical observation of different anesthetic methods in radical mastectomy operation

目的 :比较三种不同麻醉方法用于乳腺癌根治术的实用价值。方法 :对我院收治的 177例乳腺癌病人 ,按麻醉方法分硬膜组 ( 6 0例 )、静脉组 ( 5 0例 )和全麻组 ( 6 7例 ) ,比较三种麻醉方式术中使用止血药百分比和术后苏醒情况。并从三组各随机抽取 2 0例 ,比较三组病人麻醉前、麻醉后 15、30、6 0、90minHR、SBP、DBP、SPO2 变化。结果 :术中止血药使用率静脉组显著高于硬膜组及全麻醉组 (P <0 0 1) ,术后苏醒延长静脉组显著长于硬脉组及全麻组。静脉组麻醉后HR、SBP、DBP先下降 ,后上升 ,麻醉后 15minDBP明显降低 (P <0 0 1)、6 0min升高 (P <0 0 5 )、90min明显升高 (P <0 0 1) ;硬膜组麻醉后 6 0、90minHR显著降低 (P <0 0 1) ;全麻组SPO2 术各时点显著升高 (P <0 0 1)。结论

Purpose:To compare the value of three anesthetic methods in breast cancer radical operation.Methods:177 cases of breast cancer were divided into three groups. Group Ⅰ was 60 cases with epidural block anesthesia, group Ⅱ was 50 cases with intravenous anesthesia and group Ⅲ was 67 cases with intravenous combined inhalation anesthesia. The percentage of using haemostatic drug in the operation and the awakening of the three groups were compared. At random 20 cases in every group, their HR,SBP,DBP,SPO 2 at 15',30',60',90' before and after the operation were compared.Results:The use rate of haemostatic drug was significan ly higher in group Ⅱ than in group Ⅰ and group Ⅲ. In group Ⅱ, first the HR,SBP,DBP decreased and then increased, DBP decreased significanthly at 15' after anesthesia ( P <0.01), increased at 60' and increased significantly at 90' after anesthesia ( P <0 01); In group Ⅰ, HR decreased significantly at 60' and 90' after anesthesia ( P <0 01). Conclusions:High level epidural block anesthesia and intravenous combined inhalation anesthesia are more valuable than intravenous balanced anesthesia in breast cancer radical operation.