文章摘要
罗红霞 蔡翼△ 彭强 郑霞 杨柳.硬膜外复合全身麻醉对开胸手术患者麻醉苏醒期苏醒质量和应激状态的影响[J].,2016,16(19):3738-3740
硬膜外复合全身麻醉对开胸手术患者麻醉苏醒期苏醒质量和应激状态的影响
Effect of Epidural Combined with General Anesthesia on Quality and StressState in Recovery Period of Anesthesia in Patients Undergoing OpenThoracic Surgery
  
DOI:
中文关键词: 硬膜外复合全身麻醉  开胸手术  镇静  应激反应
英文关键词: Epidural combined with general anesthesia  Open thoracic surgery  Composed  Stress response
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作者单位
罗红霞 蔡翼△ 彭强 郑霞 杨柳 重庆医科大学附属永川医院麻醉科 
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中文摘要:
      目的:探讨硬膜外复合全身麻醉对开胸手术患者麻醉苏醒期苏醒质量和应激状态的影响。方法:选择2013 年6 月~2015 年 3 月在我院行开胸手术患者80 例作为研究对象,按照数字随机表法分为对照组和观察组,分别给予静吸复合全身麻醉和硬膜外 复合全身麻醉,比较两组患者术后苏醒的时间和拔管的时间,采用运动活动评分(MAAS)评估镇静程度,电化学法测定去肾上腺 素(NE)、肾上腺素(E)及多巴胺(DA)水平。结果:观察组的苏醒时间为(7.12± 1.23)min,拔管时间为(11.38± 1.86)min,均短于对 照组的(15.34± 2.82)min 和(25.71± 4.22)min,差异有统计学意义(P<0.01)。术后0.5 h及术后6 h两组患者的MAAS 均高于术 前,且观察组优于对照组,差异均有统计学意义(P<0.05)。两组患者术后NE、E 及DA水平均高于术前,且对照组高于观察组,差 异有统计学意义(P<0.05)。结论:开胸手术患者采用硬膜外复合全身麻醉可缩短苏醒时间和拔管时间,提高患者的苏醒质量,降低 应激反应,值得临床推广应用。
英文摘要:
      Objective:To study the effect of epidural combined with general anesthesia on quality and stress state in the recovery period of anesthesia in patients undergoing open thoracic surgery.Methods:A total of 80 patients, who underwent thoracic surgery in Yongchuan Hospital Affiliated to Chongqing Medical University fromJune 2013 to March 2015, were selected and randomly divided into control group and observation group. The control group was treated with general anesthesia compound epidural,and the observation group was treated with epidural combined general anesthesia. The waking time and extubation time of the two groups after operation were compared. The degrees of sedation of the two groups were assessed by the mindful attention awareness scale(MAAS). The levels of norepinephrine(NE), epinephrine(E) and dopamine(DA) of the two groups were detected by electrochemical process.Results:The waking time (7.12± 1.23 min) and extubation time (11.38± 1.86 min) of the observation group were shorter than those (15.34± 2.82min) and (25.71± 4.22 min) of the control group, the differences were statistically significant(P<0.01). The MAAS in the two groups after 0.5 h and 6h operation were higher than before operation, and the MAAS of the observation group was superior to the control group, the differences were statistically significant (P<0.05). The levels of NE, E and DA in the two groups after operation were higher than before operation, and the levels of NE, E and DA of the observation group was lower than those of the control group, the differences were statistically significant (P<0.05).Conclusion:The application of epidural combined general anesthesia to the patients undergoing thoracic surgery can shorten the awaking time and extubation time, improve the quality of the resurgence, and reduce the stress response, which is worthy of clinical popularization and application.
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