腹腔镜结直肠癌根治术患者应用不同麻醉镇痛方式的术后转归效果差异

Differences in postoperative outcomes of patients undergoing laparoscopic radical resection of colorectal cancer with different anesthesia and analgesia

目的对不同麻醉镇痛方式应用于腹腔镜结直肠癌根治术患者的术后转归效果进行分析。方法分组研究2015年6月～2017年3月期间本院收治的行腹腔镜结直肠癌根治术患者74例,选择随机数字表法的分组方法,共分成两组,其中对照组与试验组中的患者均为37例,对照组选择静脉镇痛,试验组选择硬膜外镇痛,比较两组镇痛药物用量、镇痛效果及术后转归情况。结果试验组舒芬太尼、麻黄碱、七氟醚用量明显少于对照组,组间差异具有统计学意义(P<0.05);试验组术后1 h、6 h、12 h、24 h、48 h的VAS评分均低于对照组,差异存在统计学意义(P<0.05);将两组肠道功能恢复时间、下床活动时间以及进食时间展开比较,对照组均显著长于试验组,组间差异具有统计学意义(P<0.05)。结论与全麻联合静脉麻醉相比,全麻联合硬膜外镇痛可显著提高腹腔镜结直肠癌根治术患者的镇痛效果,促进术后转归,值得临床优先选择和推广。

Objective To analyze the postoperative outcomes of different anesthesia analgesia in patients undergoing laparoscopic radical resectionof colorectal cancer. Methods A total of 74 patients undergoing laparoscopic radical resection of colorectal cancer admitted to our hospitalfrom June 2015 to March 2017 were enrolled in this study. The randomized digital table method was used to divide the patients into two groups,including the control group and the experimental group. All the patients were in 37 cases. The control group chose intravenous analgesia. The experimentalgroup chose epidural analgesia. The dosage of analgesic drugs, analgesic effect and postoperative outcome were compared between thetwo groups. Results The doses of sufentanil, ephedrine and sevoflurane in the experimental group were significantly lower than those in the controlgroup. The difference between the two groups was statistically significant （P〈0.05）. The VAS scores at 1 h, 6 h, 12 h, 24 h and 48 h after operationin the experimental group. The difference was statistically significant （P〈0.05）. The recovery time of the intestinal function, the time ofgetting out of bed and the eating time were compared. The control group was significantly longer than the experimental group, and there was statisticaldifference between the groups （P〈0.05）. Conclusion Compared with general anesthesia combined with intravenous anesthesia, general anesthesiacombined with epidural analgesia can significantly improve the analgesic effect of patients undergoing laparoscopic radical resection ofcolorectal cancer, and promote postoperative outcome, which is worthy of clinical preference and promotion.