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目的探讨气管插管全身麻醉联合舒芬太尼腰麻对腹腔镜直肠癌根治术患者心输出量影响。方法选取医院收治的直肠癌患者60例,随机分为A组、B组及C组,每组20例。A组患者予以单纯气管插管全身麻醉,B组患者予以气管插管全身麻醉联合布比卡因蛛网膜下腔麻醉和脊椎麻醉(以下简称腰麻),C组患者予以气管插管全身麻醉联合舒芬太尼腰麻。比较2组患者麻醉前(T_0)、全麻诱导后1 min(T_1)、切皮后1 min(T_2)、手术开始后10 min(T_3)、手术开始后30 min(T_4)、手术开始后60 min(T_5)时血流动力学指标[心排血量(CO)、外周血管阻力(SVR)、心肌加速度指数(ACI)、胸液成分(TFC)],手术时间,麻醉效果,观察2组患者并发症发生情况。结果 T_0时3组CO、ACI、SVR、TFC比较,差异无统计学意义(P>0.05);T_1时A组和C组CO、ACI、SVR、TFC比较,差异无统计学意义(P>0.05);T_2、T_3、T_4时A组和C组CO、ACI、SVR、TFC比较,差异有统计学意义(P<0.05);T_1、T_2、T_3、T_4时B组和C组CO、ACI、SVR、TFC比较,差异有统计学意义(P<0.05);T_2、T_3、T_4时A组CO、ACI、SVR、TFC与T_0比较,差异有统计学意义(P<0.05);T_1、T_2、T_3、T_4时B组O、ACI、SVR、TFC与T_0比较,差异有统计学意义(P<0.05);T_1、T_2、T_3、T_4时C组CO、ACI、SVR、TFC与T_0比较,差异无统计学意义(P>0.05)。3组患者手术时间、麻醉效果比较,差异无统计学意义(P>0.05)。3组患者恶心呕吐、苏醒延迟、低氧血症并发症发生率比较,差异无统计学意义(P>0.05),A组患者出现燥动发生率高于B组、C组,差异有统计学意义(P<0.01)。结论气管插管全身麻醉联合舒芬太尼腰麻对腹腔镜直肠癌根治术患者的CO、ACI、SVR、TF影响较小,有利于术患者后恢复。
Objective To investigate the effect of tracheal intubation combined with sufentanil and spinal anesthesia on cardiac output in patients undergoing laparoscopic radical resection of rectal cancer. Methods Sixty patients with rectal cancer admitted to our hospital were randomly divided into A group, B group and C group, with 20 cases in each group. Group A patients underwent simple tracheal intubation general anesthesia, group B patients underwent tracheal intubation general anesthesia combined with bupivacaine subarachnoid anesthesia and spinal anesthesia (hereinafter referred to as spinal anesthesia), C group were tracheal intubation general anesthesia Sufentanil spinal anesthesia The T_0 before anesthesia, T 1 after induction of anesthesia, T 2 after incision, T 2 after surgery, T 3 after surgery, T 4 after surgery, The hemodynamics (CO, SVR, ACI, TFC) at 60 min (T_5), operation time, anesthetic effect, observation 2 Group of patients with complications. Results There were no significant differences in CO, ACI, SVR and TFC between the three groups at T_0 (P> 0.05). There was no significant difference in CO, ACI, SVR and TFC between groups A and C at T_1 (P <0.05). The levels of CO, ACI, SVR and TFC in group A and group C at T_2, T_3 and T_4 were significantly different from each other at T_1, T_2, T_3 and T_4 (P <0.05). There were significant differences in the levels of CO, ACI, SVR, TFC and T_0 between T_2, T_3 and T_4 (P <0.05) There were significant differences in O, ACI, SVR, TFC and T_0 between group T_3 and T_4 (P <0.05), while group C, ACI, SVR, TFC and T_0 of group T_1, T_2, T_3 and T_4 were significantly different No statistical significance (P> 0.05). There was no significant difference in the operation time and anesthesia between the three groups (P> 0.05). There was no significant difference in the incidence of nausea and vomiting, delayed recovery and hypoxemia complication between the three groups (P> 0.05). The incidence of dryness in group A was higher than that in group B and C Significance (P <0.01). Conclusion Tracheal intubation general anesthesia combined with sufentanil spinal anesthesia has little effect on CO, ACI, SVR and TF in patients undergoing laparoscopic radical resection of rectal cancer, which is beneficial to the recovery of patients after operation.