腰麻-硬膜外联合麻醉及全凭静脉麻醉用于经皮肾镜碎石术的麻醉效果比较

发布时间：2018-12-31 09:46

【摘要】：目的探讨在经皮肾镜碎石术中,分别采用腰麻-硬膜外联合麻醉和全凭静脉麻醉的临床麻醉作用效果。方法选取80例经皮肾镜碎石患者在我院接受治疗的患者,以随机数字表法将患者分成两组,实行腰麻-硬膜外联合麻醉方法设为A组,实行全凭静脉麻醉方法为B组。观察两组患者麻醉前后血压、心率的变化情况、临床麻醉效果以及不良反应发生率。结果在麻醉前,A组患者的血压、心率、血氧饱和度与B组相比没有明显差异;在Tb、Tc、Td、Te时,A组患者的血压、心率、血氧饱和度与B组相比明显较低;在Tf时,A组患者的血压、心率、血氧饱和度与B组相比明显较高;A组患者的麻醉起效时间(25.46±8.48)s、总阻滞时间(15.34±5.11)min、苏醒时间(14.34±4.78)min与B组患者的麻醉起效时间(38.56±12.88)s、总阻滞时间(10.45±3.15)min、苏醒时间(19.56±6.88)min相比具有显著差异;A组患者不良反应如温度过低、苏醒延迟以及心动过缓的发生率显著低于B组的,差异具统计学意义(P0.05)。结论经皮肾镜碎石术采用CSEA方法可以缩短临床麻醉起效和苏醒时间,降低临床不良反应的发生,是临床麻醉的首选方式。对于临床手术条件较差和手术时间延长的患者TIVA更适宜。
[Abstract]:Objective to investigate the effect of combined spinal-epidural anesthesia and total intravenous anesthesia in percutaneous nephrolithotripsy. Methods 80 patients who were treated with percutaneous nephrolithotripsy in our hospital were randomly divided into two groups: group A with combined spinal-epidural anesthesia and group B with total intravenous anesthesia. The changes of blood pressure, heart rate, clinical anesthetic effect and incidence of adverse reactions were observed before and after anesthesia. Results there was no significant difference in blood pressure, heart rate and oxygen saturation between group A and group B before anesthesia, but the blood pressure, heart rate and oxygen saturation in group A were significantly lower than those in group B during Tb,Tc,Td,Te. At Tf, the blood pressure, heart rate and oxygen saturation in group A were significantly higher than those in group B; The onset time of anesthesia in group A was (25.46 卤8.48) s, the recovery time of total block was (15.34 卤5.11) min, (14.34 卤4.78) min, and the onset time of anesthesia in group B was (38.56 卤12.88) s. The total block time was (10.45 卤3.15) min, recovery time (19.56 卤6.88) min. The incidence of adverse reactions such as low temperature, delayed recovery and bradycardia in group A was significantly lower than that in group B (P0.05). Conclusion percutaneous nephrolithotripsy with CSEA method can shorten the onset and recovery time of clinical anesthesia and reduce the occurrence of clinical adverse reactions. It is the first choice of clinical anesthesia. TIVA is more suitable for patients with poor clinical operating conditions and prolonged operation time.
【作者单位】：广东省茂名市人民医院麻醉手术科;
【分类号】：R614

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