两种麻醉方法在老年患者腹腔镜胆囊切除术中的应用

Application of two anesthetic methods in elderly patients with laparoscopic cholecystectomy

目的研究不同麻醉方法在老年腹腔镜胆囊切除术(LC)中的应用效果。方法回顾性分析在我院行LC治疗的112例老年患者的临床资料,根据麻醉方式不同分为对照组(单纯全身麻醉)和观察组(硬膜外麻醉复合全身麻醉),每组56例。比较两组的麻醉效果。结果对照组插管后5min、气腹后10min、拔管后的心率、SBP、DBP、外周血p-selectin及ICAM-1均高于观察组(P<0.05);观察组麻醉起效时间、术后清醒时间、VAS评分显著低于对照组,不良反应发生率高于对照组(P<0.05)。结论硬膜外麻醉复合全身麻醉应用于LC中的效果更佳,但可能增加不良反应的发生风险。

Objective To investigate the effects of different anesthetic methods in elderly patients with laparoscopic cholecystectomy（LC）. Methods The clinical data of 112 elderly patients with LC in our hospital were retrospectively analyzed. The patients were divided into control group（general anesthesia only） and observation group（epidural anesthesia combined general anesthesia） according to the different anesthetic methods, with 56 cases in each group. The anesthetic effects of the two groups were compared. Results The heart rate, SBP, DBP, peripheral blood p-selectin and ICAM-1 levels of the control group at 5 min after intubation, 10 min after pneumoperitoneum and after extubation were significantly higher than those in the observation group（P 〈0.05）; the anesthesia onset time, postoperative awake time, VAS score in the observation group were significantly lower, the incidence of adverse reactions was higher than those in the control group（P〈0.05）. Conclusion Epidural anesthesia combined with general anesthesia is better for maintaining hemodynamic stability in elderly patients with LC, but it is relatively possible to increase the risk of adverse reactions.