全身麻醉联合硬膜外麻醉对妇科腹腔镜手术患者相关因子影响

The of general anesthesia combined with epidural anesthesia on the levels of related factors of women with gynecologic laparoscopic surgery

目的:探讨全身麻醉联合硬膜外麻醉对妇科腹腔镜手术患者相关因子水平影响。方法:选择2016年5月-2018年5月本院收治并拟行腹腔镜治疗的94例妇科疾病患者为研究对象,随机分为对照组和观察组各47例。对照组实施全身麻醉,观察组实施全身麻醉联合硬膜外麻醉,分别于麻醉前(T1)、气腹时(T2)、手术结束前10min(T3)时测定两组患者应激反应指标、凝血功能、内分泌指标、免疫指标及其他指标水平变化。结果:T1时,两组患者的各项指标不存在差异(P>0.05);T2、T3时,观察组患者的应激反应指标(SOD、MDA、ET 1)、凝血功能(APTT、PT、PLT、D Dimer)、内分泌指标(NE、Cor、Ins、C P、FT3、FT4)、免疫指标(CD3^+、CD4^+、CD8^+)及其他相关指标(TXB2、6 K PGF1α、TXB2/6 K PGF1α)水平均优于对照组(P<0.05)。结论:在妇科腹腔镜手术中应用全身麻醉联合硬膜外麻醉,可以有效改善患者的应激、凝血、内分泌、免疫等相关指标,从而更利于患者生命体征的稳定和手术的顺利进行。

Objective:To investigate the influence of general anesthesia combined with epidural anesthesia on the level of related factors of women with gynecologic laparoscopic surgery.Methods:94 women who planned to undergo gynecologic laparoscopic surgery laparoscopic were divided randomly into control group and observation group(47 cases in each group)from May 2016 to May 2018.The women in the control group had received general anesthesia,and the women in the observation group had received general anesthesia combined with epidural anesthesia.The indexes of stress response,coagulation function,endocrine and immune,and other indexes of women before anesthesia(T1),during pneumoperitoneum(T2),and 10min before operation end were measured and compared between the two groups.Results:At T1,there were no significant difference in the indexes between the two groups(P>0.05).At T2 and T3,there were significant differences in levels of stress response index(SOD,MDA,ET 1),coagulation function(APTT,PT,PLT,D Dimer),endocrine index(NE,Cor,Ins,C P,FT3,FT4),immune index(CD3^+,CD4^+,CD8^+),and other related indexes(TXB2,6 K PGF1α,TXB2/6 K PGF1α)of women between the two groups(P<0.05).Conclusion:General anesthesia combined with epidural anesthesia during gynecologic laparoscopic surgery can significantly improve related indicators,such as stress,coagulation,endocrine and immunity of women,which are more beniffit to the stability of vital signs,and can improve the operation smoothly.