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目的探讨乳腺癌患者根治术中实施硬膜外阻滞复合全身麻醉的效果。方法回顾性选取2013年8月至2014年12月在吉林省东丰县医院行乳腺癌根治术的患者76例,按随机数字表法将其分为观察组和对照组,各38例。观察组患者给予硬膜外阻滞复合全身麻醉,对照组患者行单独全身麻醉,比较两组患者麻醉诱导前(T0)、气管插管前(T1)、气管插管时(T2)、切皮时(T3)、拔管时(T4)的收缩压(SBP)、舒张压(DBP)、心率(HR)、动脉血氧饱和度(Sa O2)以及术后恢复和苏醒期情况。结果观察组患者T0、T2、T3、T4阶段SBP、DBP均明显低于对照组,T1、T2、T3阶段Sa O2明显高于对照组,差异均有统计学意义(均P<0.05);观察组患者的呼吸恢复时间、苏醒时间均明显短于对照组,差异均有统计学意义(均P<0.05);观察组患者苏醒期躁动以及疼痛发生率均明显低于对照组,差异均有统计学意义(均P<0.05)。结论硬膜外阻滞复合全身麻醉可提高乳腺癌患者根治术的实施效果,稳定患者血流动力学,降低其苏醒期疼痛及躁动发生率,术后患者苏醒较快,可作为乳腺癌根治术的首选麻醉方式。
Objective To investigate the effect of epidural block combined with general anesthesia in radical mastectomy for patients with breast cancer. Methods A total of 76 patients with breast cancer undergoing radical mastectomy in Dongfeng County Hospital of Jilin Province from August 2013 to December 2014 were retrospectively selected and divided into observation group and control group according to the random number table method, with 38 cases in each group. Patients in the observation group were given epidural block combined with general anesthesia and patients in the control group were given general anesthesia alone. T0, T1, T2, Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), arterial oxygen saturation (Sa O2) at T3, extubation T4, and recovery and wakefulness after surgery. Results The levels of SBP and DBP in T0, T2, T3 and T4 in the observation group were significantly lower than those in the control group, and Sa O2 in T1, T2 and T3 phases were significantly higher than those in the control group (all P <0.05) The resuscitation time and the recovery time of the patients in the two groups were significantly shorter than those in the control group (all P <0.05). The restlessness and pain rate in the observation group were significantly lower than those in the control group Significance (both P <0.05). Conclusion Combined epidural anesthesia with general anesthesia can improve the effect of radical mastectomy in patients with breast cancer, stabilize the hemodynamics of patients and reduce the incidence of pain and agitation during the recovery phase. The postoperative patients wake up quickly and can be used as radical mastectomy for breast cancer The preferred method of anesthesia.