全麻与硬膜外麻醉用于老年结石性胆囊炎的术中应激比较

张洁，贾爱霞

（定边县中医医院，陕西 榆林，718699）

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摘要：

目的 比较全麻与硬膜外麻醉用于老年结石性胆囊炎的术中应激情况。方法 纳入在我院接受腹腔镜胆囊切除术的80 例老年结石性胆囊炎患者作为研究对象，采用随机抽签法分为观察组和对照组，各40 例。观察组患者行硬膜外麻醉，对照组患者行全身麻醉。比较两组患者术中SBP、DBP 及HR等应激指标变化情况，并记录两组患者自主呼吸恢复时间、意识完全清醒时间及躁动发生情况。结果 观察组患者手术30 min（T2）、手术60 min（T3）及手术结束时（T4）的SBP、DBP及HR水平与 麻醉诱导前（T1）比较，无显著性差异（P>0.05）。对照组患者T2、T3 及T4 的SBP、DBP 及HR 水平与T1 比较，差异显著（P<0.05）。观察组自主呼吸恢复时间、术后躁动发生率及意识完全清醒时间均显著优于对照组（P<0.05）。结论 硬膜外麻醉用于老年结石 性胆囊炎手术中，有助于维持血流动力学稳定，减轻应激反应，缩短术后麻醉苏醒时间。

关键词：全麻；硬膜外麻醉；老年结石性胆囊炎；应激反应

中图分类号：R614.2文献标志码：A文章编号：2096-1413(2017)20-0068-02

Comparison of intraoperative stress response between general anesthesia and epidural anesthesia

in senile calculous cholecystitis
ZHANG Jie, JIA Ai-xia
(Traditional Chinese Medicine Hospital of Dingbian County, Yulin 718699, China)

ABSTRACT: Objective To compare the intraoperative stress response of the general anesthesia and epidural anesthesia in elderly patients with calculous cholecystitis. Methods Eighty cases of elderly patients with calculous cholecystitis undergoing laparoscopic cholecystectomy in our hospital were divided into observation group and control group according to random drawing method, with 40 cases in each group. The observation group received epidural anesthesia, and the control group received general anesthesia. The changes of SBP, DBP and HR were compared between the two groups, the recovery time of spontaneous breathing, conscious waking time and agitation were recorded. Results In the observation group, there were no significant differences in the SBP, DBP and HR at 30 min (T2), 60 min (T3) of operation and the end of surgery (T4) compared with before anesthesia induction (T1) (P>0.05), and in the control group, there were significant differences of each index at T2, T3 and T4 compared with T1 (P<0.05). The recovery time of spontaneous breathing, incidence rate of postoperative agitation and conscious waking time in the observation group were significantly better than those in the control group (P<0.05). Conclusion The epidural anesthesia for elderly patients with calculous cholecystitis is helpful to
maintain hemodynamic stability, reduce the stress response and shorten the recovery time of anesthesia.
KEYWORDS: general anesthesia; epidural anesthesia; elderly calculous cholecystitis; stress response

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