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目的探讨全麻复合硬外膜麻醉在食道癌手术中的临床应用价值。方法选取2014年5月~2015年6月期间我院收治的食道癌择期手术患者68例,采用随即平均分配法将其分为常规组和联合组,每组34例,联合组现采取硬膜外穿刺导管后再行气管内插管全麻;常规组仅适用全身麻醉。观察并对比两组患者的平均动脉压(MAP)、心率(HR)、术后苏醒时间、自主呼吸恢复以及拨管时间。结果果两组患者麻醉前平均动脉压、心率差异不明显,但是在H1、H2、H3、H4四个时间段联合组的MAP和HR明显低于常规组,组间差异明显(P<0.05)。联合组患者的自主呼吸恢复时间、拔管时间、完全清醒时间明显短于常规组,组间差异明显(P<0.05)。结论全麻复合硬膜外麻醉方法用于食道癌手术能够显著提升手术效果,减少麻醉药物用量,术后患者苏醒快、苏醒质量好,术后恢复时间加快。
Objective To investigate the clinical value of general anesthesia combined with epidural anesthesia in esophageal cancer surgery. Methods Sixty-eight patients with esophageal cancer undergoing elective surgery admitted to our hospital from May 2014 to June 2015 were randomly divided into routine group and combination group with 34 cases in each group. External puncture catheter followed by endotracheal intubation general anesthesia; conventional group only for general anesthesia. The mean arterial pressure (MAP), heart rate (HR), postoperative recovery time, spontaneous breathing recovery and dialing time were observed and compared between two groups. Results The mean arterial pressure and heart rate before anesthesia in the two groups were not significantly different. However, the MAP and HR in the combined group were significantly lower than those in the control group at the four time points of H1, H2, H3 and H4 (P <0.05) . The spontaneous respiratory recovery time, extubation time and complete awake time in the combined group were significantly shorter than those in the conventional group (P <0.05). Conclusion Combined general anesthesia epidural anesthesia for esophageal cancer surgery can significantly improve the surgical results, reduce the amount of anesthetic drugs, postoperative patients wake up quickly, wake up good quality, postoperative recovery time is accelerated.