老年高血压患者腹腔镜胆囊切除术麻醉方式选择研究

Study on anesthesia of laparoscopic cholecystectomy for elderly patients with hypertension

目的：进一步对老年高血压患者腹腔镜胆囊切除术麻醉方式的选择进行分析和探讨。方法：选取于2012年12月至2014年12月期间在我院行腹腔镜胆囊切除术的100例老年患者，将其作为本次的研究对象，患者分成对照组和观察组，每组各50例，对照组患者采用全身麻醉，观察组患者在此基础上联合硬膜外麻醉，观察患者的麻醉效果。结果：观察组术中血流动力学指标较对照组稳定，术后恢复自主呼吸时间（4.31±2.41）min，苏醒拔管时间（10.24±3.87）min，均优于对照组，比较两组患者的麻醉效果差异明显（P＜0.05），具有统计学意义。结论：针对行腹腔镜胆囊切除术的老年高血压患者，在其麻醉方式的选择上，通过全身麻醉联合硬膜外麻醉能够有效稳定患者术中血流动力学指标，缩短术后恢复时间，在临床上具有极为重要的意义，今后值得推广和应用。

Objective： To analyze and discuss the choosing of anesthesia methods for elderly hypertensive patients undergo laparoscopic cholecystectomy. Methods： 100 cases of elderly patients underwent laparoscopic cholecystectomy in our hospital during December 2012 to December 2014 were selected as subjects of this study. The patients were divided into a control group and an observation group with 50 patients each. The control group patients were treated with general anesthesia and patients in the observation group received epidural anesthesia on the basis of a general anesthesia. The anesthetic effects in the two groups were observed and compared. Results： Compared with that of the control group, the intraoperative hemodynamic stability of the observation group was better. And the restoration of spontaneous breathing time, （4.31±2.41） min, and awake extubation time, （10.24±3.87） min, of the observation group were better than that of the control group and the differences were of statistic significance （P〈0.05）. Conclusions： For elderly patients with hypertension to undergo laparoscopic cholecystectomy, the use of anesthesia method is critical. General anesthesia combined with epidural anesthesia can effectively stabilize hemodynamics in patients undergoing operation and shorten the recovery time after surgery. It has very important clinical significance and it is worthy of promotion and application in the future.