2016 年第 12 期 第 14 卷

黄清松硬膜外麻醉辅助静脉复合麻醉用于胃窦癌行三腔胃肠管留置术的临床效果分析

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关键词：硬膜外麻醉静脉麻醉胃窦癌血流动力学

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• 【摘要】
• Objective To investigate the application effect of epidural anesthesia combined with intravenous anesthesia in three patients with gastric antrum cancer. Methods Retrospective analysis was used to analysis the clinical data of three cavity gastric tube indwelling gastric cancer patients accept the tubular anastomat in our hospital from August 2014 to August 2016. According to the method of anesthesia, the anesthesia group was divided into intravenous anesthesia group and epidural combined intravenous anesthesia group. Observe the two groups of patients with hemodynamic parameters, surgical stress index and anesthesia effect of differences, compared with the two groups of patients with the difference of the incidence of adverse reactions. Results There was no significant difference between the two groups before anesthesia, the 2H and postoperative 4h, the insulin, cortisol and TNF- alpha of the combined anesthesia group were less than the intravenous anesthesia group (P<0.05); Before anesthesia, MAP, HR and SpO2 levels were not significantly different between the two groups. After 2H and 4h, the fluctuation of MAP and HR in the combined anesthesia group was smaller than that in the intravenous anesthesia group, and there was no difference in the level of SpO2 between the two groups; The 24h scores of 4h, 12h and VAS of the combined anesthesia group were lower than those in the intravenous anesthesia group (t=5.898, 7.794, 19.887, P<0.001); Two groups of respiratory depression, nausea and vomiting, blood pressure and heart rate decreased the incidence of adverse reactions was no difference (x2=1.385, P=0.239). Conclusion The application of epidural anesthesia combined with intravenous anesthesia in the treatment of gastric antrum cancer in three patients with gastric cancer can significantly reduce the stress reaction of patients, and the effect of anesthesia is good, and has the value of clinical application.