腹部手术患者应用三种不同麻醉方式后患者循环功能、内环境等指标变化情况观察

The changes of circulatory function, internal environment, and other indicators in patients with abdominal surgery after application of three different kinds of anesthesia methods

目的探讨腹部手术患者应用三种不同麻醉方式对患者循环功能、内环境指标的影响。方法选取2012年1月至2015年8月本院收治105例腹部手术患者随机分为A、B、C组，A组吸入七氟烷＋丙泊酚＋罗库溴铵，B组吸入七氟烷＋瑞芬太尼＋丙泊酚＋罗库溴铵，C组吸入七氟烷＋丙泊酚＋罗库溴铵＋连续硬膜外麻醉，比较三组患者循环功能、内环境及麻醉质量等。结果C组患者SBP、DBP及HR在各麻醉各时间点均稳定于A、B两组，差异有统计学意义（P〈0．05）。C组患者血pH值、PaCO2、PaO2水平在各麻醉时间点均稳定于A、B两组，差异有统计学意义（P〈0．05）。A、B两组拔管时间比较差异无统计学意义（P〉0．05）；C组拔管时间短于A、B两组[（9．47±3．46）min vs．（17．51±8．64）min，（9．47±3．46）minVS．（18．27±7．23）min；P〈0．05]。A组苏醒时间短于B组[（21．60±9．34）min vs．（25．35±8．90）min，P〈0．05]，C组苏醒时间短于A、B两组[（14．01士5．42）min vs．（21．60土9．34）min，（14．01±5．42）min vs．（25．35±8．90）min；P〈0．051。结论全麻复合硬膜外联合麻醉应用于腹部手术麻醉质量最好，为首选麻醉方法。

Objective To investigate the changes of circulatory function, internal environment, and other indicators in patients with abdominal surgery after application of three different kinds of anesthesia methods. Methods 105 cases of abdominal surgery in our hospital from January 2012 to August 2015 were selected, and randomly divided into group A, B, C. Group A inhaled sevoflurane ＋ propofol ＋ rocuronium, group B inhaled sevoflurane ＋ remifentanil ＋ propofol ＋ rocuronium, and group C inhaled sevoflurane ＋ propofol ＋ rocuronium and underwent continuous epidural anesthesia. Compared the circulatory function, internal environment, and anesthesia quality among three groups. Results SBP, DBP, HR in group C at each time point were more stable than those in group A, B, with statistically significant differences （P〈0.05）. Blood pH, PaCO2, PaO2 levels in group C at each time point were more stable than those in group A, B, with statistically significant differences （P〈0.05）. Extubation time of group C was shorter than those of group A, B [（9.47±3.46）min vs.（17.51 ±8.64）min, （9.47±3.46） min vs.（18.27±7.23）min; P〈0.05], there was no statistically significant difference in extubation time between group A and group B （P〉0.05）. Recovery time of group A was shorter than that of group B [（21.60±9.34）min vs.（25.35±8.90）min, P〈0.05], recovery time of group C was shorter than those of group A, B [（14.01±5.42）min vs.（21.60±9.34）min, （14.01±5.42）min vs.（25.35±8.90）min; P〈0.05]. Conclusion General anesthesia combined with epidural anesthesia in abdominal surgery has best anesthesia quality, can be preferred method of anesthesia.