硬膜外阻滞与硬膜外阻滞复合全麻对老年梗阻性黄疸病人循环功能的影响

EFFECT OF EPIDURAL BLOCK AND COMBINED GENERAL-EPIDURAL-ANESTHESIA ON CIRCULATING FUNCTION OF SENILE PATIENTS WITH OBSTRUCTIVE JAUNDICE

观察硬膜外阻滞与硬膜外阻滞复合全麻对老年梗阻性黄疸病人循环功能的影响并比较术中所需升压药及输液总量。方法 :将 40例梗阻性黄疸病人随机分为硬膜外组 (A组 ,n =2 0 )和硬膜外复合全麻组 (B组 ,n =2 0 ) ,观察麻醉后病人BP、HR、ECG的变化 ,术毕记录输液总量及所用升压药的种类与剂量。结果 :A组BP、HR波动显著 ,与B组比较有显著性差异 (P <0 0 5 ) ,A组需升压药维持BP者占 80 % ,明显多于B组 ,两组所输液体量B组明显少于A组。结论 :对于老年梗阻性黄疸病人的手术 ,硬膜外阻滞复合全麻优于硬膜外阻滞 ,前者对循环功能的影响较小 。

Objective:To observe the effect of epidural block and combined general-epidural-anesthesia on circulating function of senile patients with obstructive jaundice,and to compare the total amount of hypertensor and infusion during operation.Methods:40 cases of patients with obstructive jaundice were randomly divided into epidural group(group A,n=20) and combined general-epidural-anesthesia group(group B,n=20).To observe the change of BP,HR and ECG after anesthesia.To record the total amount of infusion and the denomination and dosage of hypertensor.Results:Fluctuation of BP and HR in group A was significant,there was a significant difference with those of in group B(P<0 05).What needed hypertensor to maintain BP were 80% in group A,obviously more than that of in group B.The amount of infusion was obviously less in group B than in group A.Conclusion:Combined general-epidural-anesthesia was superior to epidural block on the senile patients with obstructive jaundice.The former seldom affects the circulating function,which is more suitable to the senile patients with circulatory system diseases.