腰硬联合麻醉与硬膜外复合气管插管全身麻醉对老年腹部手术患者围术期血流动力学及心电图的影响分析

Analysis of the influence of combined spinal-epidural anesthesia and combined epidural anesthesia on perioperative hemodynamics and electrocardiogram in elderly patients undergoing abdominal surgery

目的分析比较腰硬联合麻醉与硬膜外复合气管插管全身麻醉对老年腹部手术患者围术期血流动力学及心电图的影响。方法将隆昌市人民医院2018年6月-2019年10月收治择期行腹部手术的125例老年患者作为研究对象,随机分为对照组(62例)与实验组(63例)。对照组予以腰硬联合麻醉,实验组予以硬膜外复合气管插管全身麻醉;记录比较两组患者围术期各时间点的心率(HR)、平均动脉压(MAP),血氧饱和度(Sa0_(2))等血流动力学指标变化以及异常心电图情况。结果本研究纳入患者术后无死亡病例,两组手术类型、手术时间,术中出血量等指标比较,无统计学意义(P>0.05);实验组围手术期血流动力学指标更趋于稳定,而对照组有较大波动,实验组MAP、HR、Sa0_(2)指标在麻醉后30min.拔管前1Smin.拔管时、拔管后60min各时间段与对照组比较,差异显著(P<0.05);术中实验组异常Q波、心动过速、心肌缺血异常率明显低于对照组,差异具有统计学意义(P<0.05);实验组麻醉不良反应总发生率25.40%,明显低于对照组的61.29%,差异具有统计学意义(P<0.0S)。结论硬膜外麻醉复合气管插管全身麻醉对老年腹部手术患者围术期血流动力学及心电图影响较轻,安全性较高,值得优先考虑。

0bjective To analyze and compare the efeets of epidural anesthesia and epidural anesthrsia on perioperalive hemodynamics and electrorardiogram of elderly patients undergoing abdominal surgery.Methods A total of 125 elderly patients adnmited to the hospital for eleetive abdominal surgery from June 2018 to Octoher 2019 were randomly divided into the contrl group(62 rases)and the experimental group(63 rases).The control group reerived combined lumbar and epidural anesthesia,while the experimental group received general anesthesia with combined endotracheal intubation.The changrs of hemoly namie indexcs such a heart rate(HR).mean arterial pressure(MAP),blood oxygen saturation(SaO_(2))and abnormal electrorardiogram(ECC)were rerorderd and compared between the Iwo groups a each time point during the perioperative period.Results In this study,there were no postoperative draths among the included patients,and there were no satistically signifeant dffereres between the Itwo groups in terms of operation lype.operation time.intraoperative blood loss and other indicators( P>0.05).The hemodynamic indexes of the experimental group tended to be more stable during the perioperative period,while those of the control group fluctuated greatly.The MAP,HR and SaO_(2) indexes of the experimental group were significantly different from those of the control group al each time period of 30min after anesthesia.15min before extubation.,during extubation,and 60min after extubation(P<0.05).During the operation,the abnormal rates of Q wave,tachyeardia and myocardial ischemia in the experimental group were significantly lower than those in the control group,and the differenees were staitically significant(P<0.05).The ineidence of adverse reactions in the experimental group was 25.40%significanly lower than that in the crontrol group 61.29%.and the difefrenre was statistically significant(P<0.05).Cono lus ion Epidural anesthesia combined with endotracheal intubation general anesthesia has less influence on perioperative hemody namics and electror ardingram in elderly patients undergoing abdominal surgery which is worthy of priority due to is higher safelty.