全麻复合硬膜外麻醉用于老年嗜铬细胞瘤手术及对机械通气的影响

EFFECT OF COMBINED GENERAL-EPIDURAL ANESTHESIA COMBINED EPIDURAL ANESTHESIA ON ANESTHESIA EFFICACY AND DURATION OF MECHANICAL VENTILATION IN SENILE PHEOCHROMOCYTOMA PATIENTS

目的:研究全麻复合硬膜外麻醉在老年嗜铬细胞瘤手术中的应用及对机械通气的影响。方法:选取2013年7月至2016年4月在本院行手术治疗的老年嗜铬细胞瘤患者82例,随机分为研究组和对照组,每组各41例,研究组采用全身麻醉+硬膜外麻醉,对照组采用全身麻醉,观察记录血流动力学指标、术后Ramsay镇静评分和VAS疼痛评分及机械通气时间。结果:(1)两组术后各血流动力学指标(SVR、MAP、RAP、LVSWI、CI及PAWP指数)均较手术前降低(P<0.05);研究组各指标均显著低于对照组(P<0.01)。(2)两组Ramsay镇静评分、VAS疼痛评分比较差异无统计学意义(P>0.05);(3)研究组机械通气时间显著短于对照组(t=7.829,P<0.01)。结论:全麻复合硬膜外麻醉在老年嗜铬细胞瘤手术中,麻醉效果确切,较单纯全身麻醉血流动力学更平稳,且能缩短机械通气时间,值得临床推广应用。

Objective： To investigate the clinical value of combined general-epidural anesthesia on anesthesia efficacy and duration of mechanical ventilation in senile pheochromocytoma patients. Methods： 82 cases of elderly patients with pheochromocytoma underwent surgery from July 2013 to April 2016 were randomly divided nto the study group and the control group （41 cases n each group）. The study group received gen-eral anesthesia combined with epidural anesthesia,while the control group received general anesthesia. He-modynamics ,Ramsay score,VAS score and duration of mechanical ventilation were recorded. Results： Af-ter surgery,the hemodynamic parameters （SVR , MAP , RAP , LVSWI, CI and PAWP index） in both groups were all reduced （ P 〈 0. 0 5 ） ,and the study group showed a more significant decline （ P 〈0.01）.There was no significant difference between two groups in Ramsay score and VAS score （ P 〉 0 . 05）. The duration of mechanical ventilation in the study group was significantly shorter than that in the control group （ t = 7. 829, P 〈 0. 01 ）. Conclusion ： Combined general-epidural anesthesia has a better anesthetic effect than a single general anesthesia on the treatment of senile pheochromocytoma, which stable hemodynamics and shorter duration of mechanical ventilation.