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目的：观察两个间隙联合腰麻硬膜外麻醉（Ｃｏｍｂｉｎｅｄｓｐｉｎｅｅｐｉｄｕｒａｌａｎｅｓｔｈｅｓｉａ，ＣＳＥＡ）在肾移植手术中的应用，并与两间隙双持硬麻醉（Ｄｏｕｂｌｅｃａｔｈｅｒｅｐｉｄｕｒａｌａｎｅｓｔｈｅｓｉａ，ＤＣＥＡ）下肾移植进行比较。对联合腰麻硬膜外麻醉在肾移植术中的应用作一个初步评价；方法：择期同种异体肾移植４０例，随机分为两组，每组２０例。Ａ组：采用Ｔ１２～Ｌ１与Ｔ３～Ｌ４两间隙穿刺，双持硬麻醉。Ｂ组：先行硬膜外穿刺，穿刺间隙为Ｔ１２～Ｌ１，成功置管后，再行Ｔ３～Ｌ４间隙腰穿，成功后注入１：１：１局麻混合液（１％地卡因１．０ｍＬ，１０％ＧＳ１．５ｍＬ，３％麻黄素０．５ｍＬ）２．５～３ｍＬ。改平卧位。以后根据腰麻平面，决定是否由硬膜外导管追加局麻药。两组目标麻醉平面均为Ｔ６。记录局麻药用量，辅助药用量，肌松程度，循环变化和移植肾动、静脉开放至喷尿时间及血糖变化；结果：麻醉平面达到Ｔ６时间，局麻药，辅助药总量用，两组间有明显差异（Ｐ＜０．０１～０．０５），喷尿时间，血压，心率，血糖变化在两组间无明显差异（Ｐ＜０．０５）；结论：ＣＳＥＡ兼具有腰麻、硬膜外麻醉的优点，具备局麻药用量少，麻醉潜伏期短，?
OBJECTIVE: To observe the application of two space combined spinal anesthesia with spinal cord anesthesia in kidney transplantation and compare with renal transplantation under double-capped spinal anesthesia (DCEA). A preliminary evaluation of the application of spinal anesthesia combined with spinal anesthesia in renal transplantation; Methods: 40 cases of elective allogeneic kidney transplantation were randomly divided into two groups of 20 cases. Group A: using T12 ~ L1 and T3 ~ L4 two puncture, double-hard anesthesia. Group B: The first epidural puncture, the puncture space for the T12 ~ L1, after successful catheterization, and then T3 ~ L4 clearance lumbar puncture, after successful injection of 1: 1: 1 local anesthetic mixture (1% 0 mL, 10% GS 1.5 mL, 3% Ephedrine 0.5 mL) 2.5-3 mL. Change supine position. After the plane according to spinal anesthesia, decide whether to add local anesthetic epidural catheter. The two groups of target anesthesia plane are T6. The amount of anesthetic, auxiliary dose, degree of muscle relaxation, circulatory changes and renal transplant, venous open to urinary time and blood glucose changes were recorded. Results: The anesthesia level reached T6 time, There were significant differences between the two groups (P <0.01 ~ 0.05). There was no significant difference in urinary time, blood pressure, heart rate and blood glucose between the two groups (P <0.05) The advantages of epidural anesthesia, with less amount of local anesthetic, anesthesia incubation period is short ,?