周敏 洪甲庚

【摘要】 目的：探討硬膜外麻醉复合全身麻醉在直肠癌根治术中的作用。方法：以2018年1-12月在笔者所在医院接受直肠癌根治术的74例患者为本次研究对象，按入院顺序分为对照组和观察组，各37例。对照组给予全身麻醉，观察组给予硬膜外联合全身麻醉，对比两组麻醉效果。结果：插管前，两组平均动脉压（MAP）、心率（HR）对比，差异均无统计学意义（P>0.05）;插管时、切皮时、拔管时，观察组MAP、HR均低于对照组，差异均有统计学意义（P<0.05）;拔管后15 min，两组MAP、HR对比差异均无统计学意义（P>0.05）;观察组睁眼时间、拔管时间均早于对照组，认知功能评分高于对照组，差异均有统计学意义（P<0.05）;观察组不良反应发生率为10.81%（4/37），低于对照组，差异有统计学意义（P<0.05）。结论：对直肠癌根治术患者实施硬膜外联合全身麻醉，术中患者生命体征更为稳定，且对认知功能影响小，不良反应少，具有极高的应用价值。

【关键词】 硬膜外麻醉; 全身麻醉; 直肠癌根治术; 认知评分

doi：10.14033/j.cnki.cfmr.2019.27.003 文献标识码 A 文章编号 1674-6805（2019）27-000-03

The Effect of Epidural Anesthesia Combined with General Anesthesia on Radical Resection of Rectal Cancer/ZHOU Min，HONG Jiageng.//Chinese and Foreign Medical Research，2019，17（27）：-7

【Abstract】 Objective：To investigate the effect of epidural anesthesia combined with general anesthesia on radical resection of rectal cancer.Method：A total of 74 patients who underwent radical resection of rectal cancer in our hospital from January to December 2018 were selected as the study objects，and patients were divided into the control group and the observation group according to the order of admission，37 cases in each group.The control group was given general anesthesia，while the observation group was given epidural anesthesia combined general anesthesia.The anesthetic effect of the two groups was compared.Result：Before intubation，the mean arterial pressure（MAP） and heart rate（HR） of the two groups were compared，and the differences were not statistically significant（P>0.05）.The levels of MAP and HR in the observation group were lower than those of the control group at intubation，skin incision and extubation，and the differences were statistically significant（P<0.05）.15 minutes after extubation，the levels of MAP and HR of the two groups were compared，and the differences were not statistically significant（P>0.05）.The time of opening eyes and extubation in the observation group were earlier than those of the control group，and the cognitive function score was higher than that of the control group，and the differences were statistically significant（P<0.05）.The incidence of adverse reactions in the observation group was 10.81%（4/37），which was lower than that of the control group，and the difference was statistically significant（P<0.05）.Conclusion：Epidural anesthesia combined with general anesthesia for patients undergoing radical resection of rectal cancer has more stable intraoperative vital signs，less impact on cognitive function and less adverse reactions.It has a very high application value.

【Key words】 Epidural anesthesia; General anesthesia; Radical resection of rectal cancer; Cognitive score

First-authors address：First Affiliated Hospital of Xiamen University，Xiamen 361003，China

临床研究发现，在实施直肠癌根治术过程中，麻醉方法与手术效果间存在密切的相关性[1]。对于直肠癌患者来说，常伴有营养不良、脏器功能减退、水电解质紊乱等现象，在手术过程中，患者常出现强烈的应激反应，进一步增加机体功能损害[2]。以往，临床对患者进行手术前，均采用全身麻醉的形式，但是患者在手术过程中，各项指标波动较大，且极易发生不良反应[3]。因此，在手术前必须要选择科学、合理的麻醉方式。为了进一步研究硬膜外麻醉复合全身麻醉在直肠癌根治术中的作用，以2018年1-12月在笔者所在医院接受直肠癌根治术的74例患者为本次研究对象，进行如下总结。

1 资料与方法

1.1 一般资料

以2018年1-12月在笔者所在医院接受直肠癌根治术的74例患者为本次研究对象。纳入标准：均经病理学诊断证实，且符合手术指征。排除……