连续硬膜外麻醉与全身麻醉在子宫内膜癌患者中的应用效果

Application effect of continuous epidural anesthesia and general anesthesia in patients with uterine corpus endometrial carcinoma

目的探讨连续硬膜外麻醉(CEA)与全身麻醉(GA)在子宫内膜癌(UCEC)患者中的应用效果。方法选取2020年6月至2021年6月在本院行手术治疗的72例UCEC患者作为研究对象,采用简单随机化法将其分为CEA组和GA组,各36例。两组均行根治性子宫切除术,CEA组采用CEA,GA组采用GA。比较两组术后不同时间点的镇痛效果、不同时间点右下肢腘静脉的血流速度及血流量、不同时间点的应激反应指标水平及不良反应发生情况。结果术后6 h,CEA组的VAS评分低于GA组,差异具有统计学意义(P<0.05)。术前、术中、术后1 h,CEA组右下肢腘静脉的最高血流速度、平均血流速度、血流量均高于GA组,差异具有统计学意义(P<0.05)。术后6 h,两组的Cor、NE、β-EP水平均升高,但CEA组低于GA组,差异具有统计学意义(P<0.05)。两组的不良反应总发生率无显著差异(P=0.453)。结论与GA相比,CEA应用于UCEC患者中可缓解术后疼痛程度,减轻对右下肢腘静脉血流速度、血流量及应激反应指标水平的影响。

Objective To investigate the application effect of continuous epidural anesthesia(CEA)and general anesthesia(GA)in patients with uterine corpus endometrial carcinoma(UCEC).Methods A total of 72 patients with UCEC who underwent surgery in our hospital from June 2020 to June 2021 were selected as the research objects.The patients were divided into CEA group and GA group by simple randomization,with 36 cases in each group.Radical hysterectomy was performed in both groups,the CEA group adopted CEA and the GA group adopted GA.The analgesic effect at different time points after operation,blood flow velocity and blood flow of popliteal vein of right lower limb at different time points,and stress response indexes levels at different time points and adverse reactions were compared between the two groups.Results Six hours after operation,the VAS score of the CEA group was lower than that of the GA group,and the difference was statistically significant(P<0.05).Before,during and 1 h after operation,the highest blood flow velocity,average blood flow velocity and blood flow of popliteal vein of right lower limb in the CEA group were higher than those in the GA group,and the differences were statistically significant(P<0.05).Six hours after operation,Cor,NE andβ-EP levels in the two groups increased,but those in the CEA group were lower than the GA group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P=0.453).Conclusion Compared with GA,CEA applied in patients with UCEC can alleviate the degree of postoperative pain and reduce the effects on blood flow velocity,blood flow of popliteal vein of right lower limb and stress response indexes levels.