硬膜外麻醉联合全身麻醉在胃癌根治术患者中的应用效果

Application effects of epidural anesthesia combined with general anesthesia in patients undergoing radical gastrectomy

目的:观察硬膜外麻醉联合全身麻醉在胃癌根治术患者中的应用效果。方法:选取2020年2月至2021年6月该院收治的98例行胃癌根治术的患者进行前瞻性研究,按照随机数字表法分为观察组与对照组各49例。两组均行胃癌根治术。术中,对照组行全身麻醉,观察组行硬膜外麻醉联合全身麻醉。比较两组术后不同时间(术后1、4、8、12、24 h)视觉模拟评分法(VAS)评分、手术时间、住院时间、不同时间(术前、术中、术后24 h)血压和不良反应发生率。结果:术后1、4、8、12、24 h,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05);观察组住院时间明显短于对照组,差异有统计学意义(P<0.05);术中,对照组收缩压、舒张压均高于术前,观察组收缩压高于术前,但观察组收缩压、舒张压均低于对照组,差异有统计学意义(P<0.05);术前、术后24 h,两组收缩压、舒张压组间比较,差异无统计学意义(P>0.05);观察组不良反应发生率为4.08%,明显低于对照组的22.45%,差异有统计学意义(P<0.05);两组手术时间比较,差异无统计学意义(P>0.05)。结论:硬膜外麻醉联合全身麻醉应用于胃癌根治术患者可降低术后VAS评分和不良反应发生率,缩短住院时间,且促进术中患者血流动力学稳定,效果优于单纯全身麻醉。

Objective: To observe application effects of epidural anesthesia combined with general anesthesia in patients undergoing radical gastrectomy. Methods: A prospective study was conducted on 98 patients who underwent radical gastrectomy in the hospital from February 2020 to June 2021. They were divided into observation group and control group according to the random number table method, 49 cases in each. Both groups underwent radical gastrectomy. During the surgery, the control group received general anesthesia, while the observation group received epidural anesthesia combined with general anesthesia. The visual analogue scale(VAS) scores at different time points(1, 4, 8, 12 and 24 h after the surgery),the operation time, the hospitalization time, the blood pressure levels at different time points(preoperative, intraoperative, 24 h after the surgery),and the incidence of adverse reactions were compared between the two groups. Results: 1, 4, 8, 12 and 24 h after the surgery, the VAS scores of the observation group were lower than those of the control group, and the differences were statistically significant(P<0.05). The hospitalization time of the observation group was significantly shorter than that of the control group, and the difference was statistically significant(P<0.05). During the surgery,the systolic blood pressure and diastolic blood pressure levels in control group were higher than those before the surgery;the systolic blood pressure in observation group was higher than that before the surgery;but the systolic blood pressure and diastolic blood pressure levels in observation group were lower than those in control group;and the differences were statistically significant(P<0.05). Before and 24 h after the surgery, there were no significant differences in the systolic blood pressure and diastolic blood pressure levels between the two groups(P>0.05). Further, the incidence of adverse reactions in the observation group was 4.08%, which was significantly lower than 22.45% in the control group, and the difference was statistically significant(P<0.05). Conclusions: Epidural anesthesia combined with general anesthesia in the patients undergoing radical gastrectomy can reduce the postoperative VAS scores and the incidence of adverse reactions, shorten the hospitalization time, and promote the stability of intraoperative hemodynamic parameters. Moreover, it is superior to single general anesthesia.