张清恩? 马爱兵?

【摘 要】目的：探讨对腹腔镜胆囊切除术患者采用单纯全麻与全麻复合硬膜外麻醉的效果差异。方法：选择我院2019年1月至2019年8月收治腹腔镜胆囊切除术患者计180例，随机分为全身麻醉对照组（n=90）与全麻复合硬膜外麻醉实验组（n=90），对比麻醉效果。结果：实验组诱导后、基础阶段、插管后、拔管后的心率以及收缩压均小于对照组，P<0.05。实验组烦躁发生率低于对照组，P<0.05，拔管时间与苏醒时间均短于对照组，P<0.05。结论：对腹腔镜胆囊切除术患者采用全麻复合硬膜外麻醉方案能够有效维持患者心率与血压的稳定，有利于患者术后的尽快苏醒，且可降低烦躁的发生率。

【关键词】腹腔镜胆囊切除术;全身麻醉;硬膜外麻醉

【中图分类号】R614 【文献标识码】A 【文章编号】1002-8714（2020）02-000-02

【Abstract】Objective： to investigate the difference in efficacy of epidural anesthesia between general anesthesia and general anesthesia in laparoscopic cholecystectomy. Methods： 180 patients with laparoscopic cholecystectomy admitted to our hospital from January 2019 to August 2019 were randomly divided into general anesthesia control group （n=90） and general anesthesia combined with epidural anesthesia experimental group （n=90）， and the anesthetic effect was compared. Results： the heart rate and systolic blood pressure after induction， basic stage， intubation and extubation in the experimental group were all lower than those in the control group （P<0.05）. The incidence of irritability in the experimental group was lower than that in the control group （P<0.05）， and the time of extubation and recovery was shorter than that in the control group （P<0.05）. Conclusion： general anesthesia combined with epidural anesthesia can effectively maintain the stability of heart rate and blood pressure in patients with laparoscopic cholecystectomy， which is conducive to the patients to wake up as soon as possible after surgery， and can reduce the incidence of irritability.

【Key words】laparoscopic cholecystectomy; General anesthesia; Epidural anesthesia

腹腔镜胆囊切除术是治疗胆囊疾病的成熟术式，疗效可靠且具有微创的优势，但手术效果的保障与麻醉效果存在密切的联系。为了让患者术后更快的蘇醒，应该合理选择麻醉方式，减少对患者的刺激，并维持适宜的麻醉深度[1]。在腹腔镜胆囊切除术中，全身麻醉与硬膜外麻醉均属于常用的麻醉方法，而近年来，复合麻醉在临床中也有较多的应用，为选择更为理想的麻醉方案，本次研究以我院收治腹腔镜胆囊切除术患者计180例为对象，评估了常规全身麻醉与全麻复合硬膜外麻醉的应用效果差异，现报告如下。

1 资料与方法

1.1临床资料

选择我院2019年1月至2019年8月收治腹腔镜胆囊切除术患者计180例，随机分为全身麻醉对照组（n=90）与全麻复合硬膜外麻醉实验组（n=90）。对照组中男54例，女36例，年龄38～82岁，均数（52.81±12.47）岁，病程1～8年，均数（6.22±1.49）年，实验组中男52例，女38例，年龄36～81岁，均数（53.11±12.08）岁，病程1～9年，均数（6.30±1.52）年，两组基础资料对比，P>0.05，具有可比性。纳入患者均符合胆囊手术指征，无麻醉禁忌症，对本次研究均知情同意，已经签署同意书。