老年高血压患者上腹部手术硬膜外复合全麻的效果观察

目的：探讨老年高血压患者上腹部手术的麻醉方法。方法：择期行胃癌根治术老年患者20倒，均按WHO标准诊断。随机分成对照组和实验组，每组10例：对照组采用单纯全麻，实验组采用硬膜外复合全麻。术中连续监测Bp、HR、SpO2、心率；并记录术中知晓、术后躁动厦麻醉药用量。结果：对照组插管及拔管时，SBP、MAP、HR、RPP均明显高于麻醉前值（P〈0.01），术后60及90minSBP、MAP、HR显著升高；同期实验组则无明显波动，两纽间比较差异有统计学意义（P〈0．01）；术毕至清醒时间；对照组（35．0±15．2）min。实验组（10．0±4．6）min，两组间比较差异有统计学意义（P〈0．01）。结论：静脉全麻复合硬膜外阻滞麻醉方法血流动力学波动小。全麻药量和术后躁动减少，病人手术后身体恢复比较快。宜用于老年高血压病人上腹部手术麻醉。

Objective： to study the anesthesia methods of abdominal surgery in elderly patients with hypertension. Methods： 20 cases got marked line of elderly patients with gastric cancer radical, were diagnosed according to the WHO standards. Randomly divided into control group and experimental group, 10 cases in each group： the control group using pure general anesthesia, the experimental group used the compound epidural anesthesia. Bp, HR, SpO2, intraoperative continuous monitoring heart rate; And record in know, postop- erative agitation and drug. Results： control group in intubation and extubation, SBP, MAP, HR and RPP were significantly higher than the value before anesthesia （P 〈 0. 01 ）, post- operative 60 and 90 minsbp significantly increased, MAP, HR, At the same time the experimental group, no obvious fluctuation, comparing differences between the two groups was sta- tistically significant （ P 〈 0. 01 ） ; Finish operation to waking hours ; The control group （35.0 ＋ 15.2） min. The experimental group （ 10. 0 ＋ 4. 6） min, comparing differences between the two groups have statistical significance （P 〈 0. 01 ）.. Conclusion： intravenous general anesthesia compound epidural block anesthesia method hemodynamic fluctuations arc small. Reduce dosage general anesthesia and postoperative agitation, patients surgery recovery faster. Should be used in abdominal surgery anesthesia on elderly hypertensive patients.