朱彩荣　马宏民　龙天柱　胡玲玉广州市妇女儿童医疗中心乳腺外科，广东广州　510623

乳腺多发性肿物Mammotome微创旋切术局部浸润麻醉与静脉麻醉的对照研究

朱彩荣马宏民龙天柱胡玲玉
广州市妇女儿童医疗中心乳腺外科，广东广州510623

目的分析乳腺后间隙局部浸润麻醉与静脉麻醉用于乳腺多发性肿物Mammotome微创旋切术临床效果，以指导临床选择应用。 方法将2013年7月～2015年9月在我院住院治疗的680例乳腺多发性肿物行微创旋切术的患者，按麻醉方式分为试验组（静脉麻醉）和对照组（乳腺后间隙局部浸润麻醉），每组340例，比较并分析两组的麻醉效果及术前、术中和术后血氧饱和度（SpO2）、平均动脉压（MAP）和心率（HR）、麻醉的不良反应发生率、患者对手术的满意度和耐受度等。结果两组麻醉成功率均为100.00%，试验组术中、术后SpO2与对照组比较，差异有高度统计学意义（P＜0.01），术中MAP、HR与对照组比较，差异有高度统计学意义（P＜0.01）。试验组患者的满意度和耐受度高，不良反应发生率低，与对照组比较，差异均具有高度统计学意义（P＜0.01）。结论乳腺多发性肿物微创旋切术采用两种麻醉方法均可以达到完成手术的麻醉效果，且安全可行，各有优势，静脉麻醉患者的满意度和耐受度较高，临床上可根据患者不同的病例特点，选取合适的麻醉方式。

局部浸润麻醉；静脉麻醉；Mammotome微创旋切系统；满意度；耐受度

［Abstract］Objective To compare and ana1yze the c1inica1 effects of the 1oca1 infi1tration anesthesia and the intravenous anesthesia app1ied in Mammotome minima11y invasive surgery in the treatment of breast mu1tip1e 1umps for guiding the anesthesia se1ection in c1inic.Methods According to the method of anesthesia，680 cases of breast mu1tip1e 1umps patients with minima11y invasive surgery in our hospita1 from Ju1y 2013 to September 2015 were divided into the experimenta1 group，which underwent the intravenous anesthesia，and the contro1 group，which underwent the 1oca1 infi1tration anesthesia.There were 340 cases in each group.The preoperative，intraoperative and postoperative parameters inc1uding the anesthesia efficacy，the b1ood oxygen saturation（SpO2），the mean arteria1 pressure（MAP），the heart rate（HR），and the incidence of adverse reactions of anesthesia，as we11 as the satisfaction degree and the to1erance degree of patients，were compared between the two groups.Results The successfu1 anesthesia rate of two group was 100.00%，statistica11y significant differences were observed in the intraoperative and postoperative SpO2（P＜0.01），there was significant difference in the intraoperative MAP and HR between the experimenta1 group and the contro1 group（P＜0.01）.Higher satisfaction degree and to1erance degree as we11 as 1ower incidence of adverse reactions of anesthesia were occurred in the experimenta1 group compared with the contro1 group（P＜0.01）.Conclusion Good anesthetic effects are achieved to comp1ete the surgery by both anesthetic methods app1ied in Mammotome minima11y invasive surgery in the treatment of breast mu1tip1e 1umps.Both anesthetic methods are safe and feasib1e，with different advantages for each method.The patients undergone the intravenous anesthesia disp1ay higher satisfaction degree and to1erance degree.Appropriate anesthesia method can be se1ected according to the characters of individua1 patients in c1inic.

［Key words］Loca1 infi1tration anesthesia；Intravenous anesthesia；Mammotome minima1 invasive system；Satisfaction degree；To1erance degree

乳腺肿块是乳腺疾病的最常见主要临床表现之一。在乳腺肿块的诊断和治疗方面，传统治疗手术麻醉方……