全身麻醉复合硬膜外麻醉在腹腔镜直肠癌切除术中的临床观察

Clinical observation of general anesthesia combined with epidural anesthesia in laparoscopic resection for rectal cancer

目的观察腹腔镜直肠癌手术中不同麻醉方法对患者术中、术后的影响，探讨腹腔镜直肠癌手术理想的麻醉方法。方法将40例腹腔镜下直肠癌切除患者（ASA Ⅰ～Ⅱ级）分为两组，A 组全身麻醉复合硬膜外麻醉（20例）、B组全身麻醉（20例）。观察患者术中血流动力学、呼吸功能、苏醒时间及苏醒质量评价。结果两组患者气道压（Paw ），呼气末CO2分压（PET-CO2）均升高。A组术中血流动力学较B组平稳。A组苏醒时间及苏醒质量优于B组。结论全身麻醉复合硬膜外麻醉用于腹腔镜直肠癌根治术较单纯应用全身麻醉，患者生命体征更平稳，苏醒质量更好，是腹腔镜直肠癌手术理想的麻醉方法。

Objective To investigate the impact of different anesthesia methods on intraoperative and postoperative patients un-dergoing laparoscopic rectal cancer surgery and to explore the ideal anesthetic method for laparoscopic rectal cancer surgery .Meth-ods 40 cases of laparoscopic resection for rectal cancer ,ASAⅠ-Ⅱ grade ,were selected and randomly divided into two groups .The group A （20 cases） was performed general anesthesia combined with epidural anesthesia and the B group （20 cases） was performed systemic anesthesia .The intraoperative hemodynamics ,respiratory function ,awaking time and awaking quality evaluation were ob-served .Results The airway pressure（Paw ） and PETCO2 in the two groups were increased .The intraoperative hemodynamics in the group A was more stable than those in the group B .The awaking time and awaking quality in the group A were superior to those in the B group .Conclusion Compared with simple general anesthesia ,general anesthesia combined with epidural anesthesia for laparo-scopic rectal cancer surgery has more stable vital signs and better awaking quality ,whoich is an ideal anesthetic method for laparo-scopic rectal cancer surgery .