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目的:探讨全身麻醉(全麻)联合硬膜外麻醉对老年结直肠癌根治术患者组织灌注及肠道屏障的影响。方法:选择我院2018年1月至2019年9月收治的118例结直肠癌老年患者为研究对象，应用随机数表法分为2组，各59例。两组患者均行结直肠癌根治术，对照组麻醉方案为全麻，观察组为全麻联合硬膜外麻醉。对比围术期两组组织灌注[中心静脉-动脉二氧化碳分压差值(Pcv-aCOn 2)、氧供指数(DOn 2I)、氧耗指数(VOn 2I)、中心静脉-动脉乳酸差值(Dcv-aLac)、氧摄取率(On 2ER)、中心静脉氧饱和度(ScvOn 2)]及肠道屏障[二胺氧化酶(DAO)、D-乳酸(D-Lac)]情况。n 结果:相较于对照组，观察组T2-T4 ScvOn 2均较高，T1-T4 VOn 2I、Dcv-aLac、Pcv-aCOn 2均较低(n P0.05)；两组D-Lac、DAO从T1-T5呈逐渐升高趋势，T5-T6呈下降趋势，且与对照组相比，观察组D-Lac、DAO在T2-T6时间段较低(n P<0.05)[腹部探查时(T1)；病灶离体(T2)；关腹前(T3)；术毕(T4)；术后第1 d(T5)；术后第3 d(T6)]。n 结论:老年患者在全麻联合硬膜外麻醉情况下开展结直肠癌根治术更利于稳定患者围术期组织灌注，有效降低肠道屏障损伤，利于提高麻醉效果。“,”Objective:To investigate the effect of the combined general and epidural anesthesia on tissue perfusion and intestinal barrier in elderly patients undergoing radical resection of colorectal cancer.Methods:A total of 118 elderly patients with colorectal cancer admitted to our hospital from January 2018 to September 2019 were randomly divided into two groups: a single general anesthesia(control, n=59)and combined general and epidural anesthesia(observation, n=59). Two groups underwent radical resection of colorectal cancer.The perioperative parameters were compared between the two groups, including tissue perfusion[central venous-to-arterial carbon dioxide difference(Pcv-aCOn 2), oxygen delivery index(DOn 2I), oxygen consumption index(VOn 2I), difference between central venous and arterial lactate(Dcv-aLac), oxygen extraction rate(On 2ER), central venous oxygen saturation(ScvOn 2)], and intestinal barrier[diamine oxidase(DAO), D-lactic acid(D-Lac)].n Results:Compared with the control group, the ScvOn 2 during T2-T4 periods was increased in the observation group, and the VOn 2I, Dcv-aLac and Pcv-aCOn 2 during T1-T4 periods were reduced in observation group(n P0.05). In the both two groups, the D-Lac and DAO levels showed a gradual upward trend during T1-T5 periods and a gradual downward trend during T5-T6 periods.The D-Lac and DAO levels during T2-T6 periods were lower in observation group than in the control group(n P<0.05)[during abdominal exploration(T1); invitrolesion(T2); before abdominal closure(T3); after surgery(T4); postoperative day 1(T5); postoperative day 3(T6)].n Conclusions:General anesthesia combined with epidural anesthesia in elderly colorectal cancer patients undergoing radical resection can stabilize perioperative tissue perfusion, decrease intestinal barrier injury and increase anesthetic effect.