不同麻醉方法对腹腔镜胆囊切除术患者围手术期应激反应的影响

Effect of Different Anesthesia Methods on Perioperative Stress Response In Patients with Laparoscopic Cholecystectomy

目的探讨不同麻醉方法对腹腔镜胆囊切除术患者围手术期应激反应的影响。方法选取本院2011年8月-2013年8月行腹腔镜胆囊切除术患者168例,随机分为研究组和对照组,各84例。研究组选择全身麻醉复合硬膜外阻滞;对照组选择全身麻醉。观察两组患者围手术期血压、心率、血糖、皮质醇、血浆β-内啡肽及白细胞介素-6的变化。结果术中及术后研究组T1、T2、T3时间点血压低于对照组(P<0.05);两组心率各时间点比较差异均无统计学意义(P>0.05);T1、T2、T3时间组点研究患者Cor、β-EP水平均低于对照组(P<0.05),两组患者血清IL-6含量均高于同组诱导前(P<0.05)。结论全身麻醉复合硬膜外阻滞较全身麻醉降低患者围手术期应激反应。

Objective To investigate the effect of different anesthesia methods on perioperative stress response in patienst with laparoscopic cholecystectomy. Methods 168 cases with laparoscopic cholecystectomy were selected from 2011 August to 2013 and the patients were randomly divided into research group and control group. Patients in research Group performed general anesthesia combined with epidural block while patients in control group performed general anesthetic. The perioperative changes in blood pressure,heart rate,blood glucose,cortisol,plasma β- endorphin and interleukin- 6 were observed. Results Intraoperative and postoperative blood pressure at T1,T2,T3 time point in research group was significantly lower than thoses in control group( P < 0. 05). Heart rate at each time point showed no significant difference between two groups( P > 0. 05). Cor,β- EP at T1,T2,T3 time point in patients were significantly lower than those in control group( P < 0. 05). The serum IL- 6 levels in two groups were higher than those before the induction( P <0. 05). Conclusion Compared with general anesthesia,general anesthesia combined with epidural anesthesia had significantly lower perioperative stress response in patients.