全麻与硬膜外麻醉对妇科腹腔镜手术患者凝血功能的影响

发布时间：2018-05-08 01:30

本文选题：妇科手术 + 腹腔镜　；参考：《山东医药》2015年25期

【摘要】：目的探讨全麻与硬膜外麻醉对妇科腹腔镜手术患者凝血功能的影响。方法将98例接受择期腹腔镜手术治疗的患者,按照麻醉方法随机分为对照组和观察组各49例,分别给予全麻与硬膜外麻醉。比较两组麻醉前、建立气腹后0.5 h、气腹停止后0.5 h、术后24 h、术后48 h、术后72 h的部分激活凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶原时间(PT)、D-二聚体水平。结果在不同时间点,两组PT水平比较均无统计学差异(P均0.05);观察组不同时间点APTT较之麻醉前均无统计学差异(P均0.05),但较对照组均有统计学差异(P均0.05);对照组APTT出现缩短现象,并维持至术后48 h(P0.05);两组FIB、D-二聚体水平较之麻醉前均升高(P均0.05),但对照组的升高幅度显著大于观察组(P均0.05)。结论较之全麻,对妇科腹腔镜手术患者实施硬膜外麻醉可以显著改善凝血功能。
[Abstract]:Objective to investigate the effect of general anesthesia and epidural anesthesia on coagulation function in gynecological laparoscopic surgery. Methods Ninety-eight patients undergoing elective laparoscopic surgery were randomly divided into control group (n = 49) and observation group (n = 49). Before anesthesia, 0.5 h after establishing pneumoperitoneum, 0.5 h after pneumoperitoneum, 24 hours after pneumoperitoneum, 48 hours after operation, 72 hours after operation, the activated thromboplastin time (APTTT), fibrinogen (FIBT), and thrombin time (PTT) were compared between the two groups. Results there was no significant difference in PT levels between the two groups at different time points (P < 0.05), and there was no significant difference in APTT between the two groups at different time points compared with that before anesthesia (P < 0.05), but there was statistical difference (P < 0.05) in comparison with the control group (P < 0.05). The level of FIBD- dimer in both groups was higher than that before anesthesia (P 0.05), but the increase in control group was significantly larger than that in observation group (P 0.05). Conclusion compared with general anesthesia, epidural anesthesia for gynecological laparoscopic surgery can significantly improve coagulation function.
【作者单位】：东营市人民医院;
【分类号】：R614

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