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目的:探讨全身麻醉复合连续硬膜外麻醉对胃癌根治患者围术期纤溶功能的影响。方法:选择2013年4月到2015年6月在我院进行胃癌根治手术的患者80例,根据随机数字表法分为治疗组40例与对照组40例,对照组给予全身麻醉,治疗组给予全身麻醉复合连续硬膜外麻醉,对两组患者血流动力学指标,纤溶功能以及下肢深静脉血栓发生情况进行观察与比较。结果:所有患者都完成手术,诱导后患者的MAP与HR值与诱导前比较差异都有统计学意义(P<0.05),不过组间对比无显著性差异(P>0.05),术毕MAP与HR值在组内与组间比较均无显著性差异(P>0.05)。治疗组诱导后5 min与术毕的血清D-二聚体和纤维蛋白原值都明显低于对照组,且与诱导前对比差异也有统计学意义(P<0.05)。治疗组术后下肢深静脉血栓发生率明显低于对照组(P<0.05)。结论:全身麻醉复合连续硬膜外麻醉能改善胃癌根治患者围术期纤溶功能,从而减轻患者高凝状态,安全性好,有效预防下肢深静脉血栓的形成。
Objective: To investigate the effect of general anesthesia combined with continuous epidural anesthesia on perioperative fibrinolytic function in patients with radical resection of gastric cancer. Methods: From April 2013 to June 2015, 80 patients with radical surgery for gastric cancer in our hospital were selected and divided into 40 cases in the treatment group and 40 cases in the control group according to the random number table. The control group was given general anesthesia and the treatment group was given General anesthesia combined with continuous epidural anesthesia, the two groups of patients with hemodynamic indicators, fibrinolytic function and the incidence of lower extremity deep venous thrombosis were observed and compared. Results: All the patients completed the operation. The MAP and HR of the patients after induction were significantly different from those before induction (P <0.05), but there was no significant difference between the two groups (P> 0.05) There was no significant difference in HR between the two groups (P> 0.05). The values of serum D-dimer and fibrinogen in the treatment group at 5 min and after operation were significantly lower than those in the control group (P <0.05). The incidence of postoperative deep venous thrombosis in the treatment group was significantly lower than that in the control group (P <0.05). CONCLUSION: Anesthesia combined with continuous epidural anesthesia can improve perioperative fibrinolytic function in patients with radical gastrectomy, thereby reducing the hypercoagulability and safety of patients with gastric cancer and effectively preventing the formation of deep venous thrombosis in lower extremities.