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目的 观察单纯全麻与全麻复合胸段硬膜外阻滞对食道癌三野根治术血液动力学的变化。方法 将3 0例ASAⅠ～Ⅲ级食道癌择期手术病人随机分为两组 :A组为全麻复合胸段硬膜外阻滞 (GA +EA ,15例 ) ;B组为单纯全麻 (GA ,15例 )。B组静注咪唑安定、芬太尼、异丙酚、维库溴铵诱导后气管插管 ,A组先行胸段硬膜外穿刺置管注药后再行气管插管 ,分别监测A、B两组插管后、术中、拔管后MAP、HR、CVP、PETCO2 各项参数变化。结果 A组MAP下降、HR减慢与麻醉前比 (P <0 .0 5 ) ;B组MAP、HR上升 (P <0 .0 5 ) ;A组MAP、HR、CVP、PETCO2 均低于B组 (P <0 .0 1)术中、术后ECG异常变化B组均大于A组 (P <0 .0 5 )。结论 食道三野手术全麻复合胸段硬膜外阻滞围术期血流动力学较单纯全麻稳定 ,但应注重血容量补充。
Objective To observe the changes of hemodynamics of three-root radical mastectomy of general anesthesia and general anesthesia combined with thoracic epidural block. Methods Thirty patients with ASA grade Ⅰ ~ Ⅲ esophageal cancer undergoing elective surgery were randomly divided into two groups: group A was general anesthesia combined with thoracic epidural block (GA + EA, 15 cases); group B was general anesthesia (GA , 15 cases). Group B received midazolam, fentanyl, propofol, vecuronium induction tracheal intubation, group A thoracic epidural catheter after intubation, tracheal intubation, respectively, monitoring A, B After intubation, intraoperative and extubation MAP, HR, CVP and PETCO2 parameters changed. Results MAP, HR, CVP and PETCO2 in group A were lower than those in group B (P <0.05), MAP and HR in group B were significantly increased (P <0.05) Group (P <0.01) intraoperative and postoperative ECG abnormal changes in group B were greater than the A group (P <0.05). Conclusions The perioperative hemodynamics of general anesthesia combined with thoracic epidural block in esophageal three-field operation is more stable than simple general anesthesia, but blood volume should be emphasized.