腰硬联合麻醉下经阴道行全子宫切除术的临床研究

Clinical study on the effect of transvaginal total hysterectomy under combined spinal epidural anesthesia

目的 探讨TVH治疗中应用腰硬联合麻醉的效果。方法 选择80例2015年12月-2016年12月在隆德县人民医院接受TVH治疗的患者,随机将患者平均分为观察组与对照组。对照组患者选择持续硬膜外麻醉,观察组患者选择腰硬联合麻醉,对比2组患者麻醉效果与VAS评分。结果 对照组与观察组患者麻醉优良率分别为75.0%、95.0%,观察组麻醉效果明显优于对照组患者（P〈0.05）;观察组与对照组患者在麻醉后1 h的咳嗽、静止状态的VAS评分差异无统计学意义;麻醉后6 h、12 h观察组咳嗽、静止状态的VAS评分明显优于对照组患者,差异具有统计学意义（P〈0.05）。结论 与硬膜外麻醉相比,腰硬联合麻醉用于全子宫切除术中具有较好的麻醉效果与镇痛效果,而且麻醉安全性也比较高,值得临床麻醉中应用与推广。

Objective To analyze the effect of transvaginal total hysterectomy under combined spinal epidural anesthesia. Methods From December 2015 to December 2016, in Longde people＆#39;s hospital 80 cases underwent transvaginal total hysterectomywere randomly divided into two groups, he observation group and the control group. The control group was treated with continuous epidural anesthesia, the observation group were given combined spinal epidural anesthesia. The anesthesia effect and VAS scores were observed and compared. Results The excellent rate of anesthesia in the observation group was 95%, which was significantly higher than 75% in the control group（P〈0.05）. 1h after anesthesia, there was no statistically significant difference in the cough and static state VAS scores between the 2 groups; 6 and 12 hours after anesthesia, the cough and static state VAS scores was significantly better than those in the control group（P〈0.05）. Conclusion Compared with epidural anesthesia, combined spinal epidural anesthesia for vaginal total hysterectomy has a better anesthetic and analgesic effect, anesthesia safety is high, it is worthy of clinical application.