全麻复合硬膜外麻醉对老年腹腔镜直肠癌手术患者应激反应的影响

Effects of general anesthesia combined epidural block to stress reaction on gerontal patient with on laparoscopic-assisted rectectomy

目的探讨全麻复合硬膜外麻醉对老年腹腔镜直肠癌手术患者应激反应的影响。方法选择我院行腹腔镜直肠癌根治术患者64例,随机分为对照组及研究组,对照组采用气管插管全麻,研究组采用气管插管全麻复合硬膜外麻醉,比较两组患者手术前、麻醉复苏前及术后第1天血糖水平(BS)、胰岛素抵抗指数(IR)以及血清皮质醇(Cor)、肾上腺素(AD)浓度的变化。结果手术前两组患者BS、IR、Cor及AD水平无显著差异(P>0.05),麻醉复苏前研究组BS、IR、Cor及AD水平高于对照组(P<0.05),术后1天研究组BS、IR、Cor及AD水平高于对照组(P<0.05)。结论全麻复合硬膜外麻醉能够减轻老年腹腔镜直肠癌根治患者应激反应,有利于减少手术创伤,增加手术及麻醉安全。

Objective To investigate the stress reaction of general anesthesia combined epidural block in gerontal patients who were treated with laparoscopic-assisted rectectomy.Methods 64 cases of gerontal patients who were treated with laparoscopic-assisted rectectomy were selected and were randomized distributed into control groups and research groups.General anaesthesia with trachea cannula were taken in control groups while general anaesthesia with trachea cannula combined epidural anesthesia were taken in research groups.Level of blood sugar （BS）,insulin resistance （RI）,cortisol （Cor）,and adrenaline （AD）were contrasted between control groups and research groups in preoeperation,before anabiosis and the day after postoperation day.Results level of BS,RI,Cor and AD were identical between control groups and research groups in preoeperation（P ＞0.05）,and level of BS,RI,Cor and AD were higher in control groups than research groups before anabiosis and after 1 day of postoperatios（P ＜0.05）.Conclusion General anesthesia combined epidural block could lessen stress reaction on gerontal patient with laparoscopic-assisted rectectomy,and was helpful lessening operation wound and improve the safety of operation and anesthesia.