两种麻醉方法在老年高血压病人腹腔镜胆囊切除手术中的应用效果分析

目的探讨全身麻醉联合硬膜外麻醉与单纯全身麻醉在高血压老年病人腹腔镜胆囊切除术中的麻醉效果。方法选择进行胆囊切除手术治疗的100例老年高血压病人，按照随机数字法分为观察组和对照组，各50例。对照组病人仅采取全身麻醉的方法，观察组病人采用全身麻醉联合硬膜外麻醉的方法，对2组病人麻醉的效果进行分析和评价。结果在实施麻醉前（T₁）、麻醉诱导后1 min（T₂）、气管插管时（T₃）、气腹时（T₄）及拔管时（T₅）各时间点，观察组病人心率、收缩压和舒张压差异均无统计学意义（P>0.05）；与T₁、T₂时间点相比，对照组的心率在T₃和T₄两个时间点上升（P < 0.01），在T₅时间点恢复到T₁、T₂水平（P>0.05）；与T₁、T₂时间点相比，对照组的收缩压和舒张压均在在T₃和T₄两个时间点下降（P < 0.01），在T₅时间点恢复到T₁、T₂水平（P>0.05）。观察组病人手术后睁眼时间、拔管时间及定向力恢复时间均短于对照组（P < 0.01），麻醉有效率为94.00%，高于对照组的80.00%（P < 0.05）。结论对进行腹腔镜下胆囊切除术的高血压老年病人采用全身麻醉联合硬膜外麻醉的方法，对病人的血流动力学影响较小，麻醉效果良好，取得了满意的临床疗效，是值得推广的一种麻醉方法。

Study on the effect comparison of two kinds of anesthesia in laparoscopic cholecystectomy in elderly hypertensive patients

ObjectiveTo compare the effects between general anesthesia combined with epidural anesthesia and general anesthesia in laparoscopic cholecystectomy in elderly patients with hypertension.MethodsA total of 100 patients treated with cholecystectomy were divided into the control group and observation group according to the random number method (50 cases each group).The control group were treated with general anesthesia, and the observation group were treated with general anesthesia combined with epidural anesthesia.The anesthesia effect between two groups was compared.ResultsThe differences of the heart rate, systolic pressure and diastolic pressure among before anesthesia(T₁), after 1min of anesthesia induction(T₂), tracheal intubation(T₃), pneumoperitoneum(T₄) and extubation(T₅) were not statistical significance in observation group(P>0.05).Compared at T₁ and T₂, the heart rates increased at T₃ and T₄(P < 0.01), and which at T₅ returned to the levels at T₁ and T₂ in control group(P>0.05).Compared at T₁ and T₂, the systolic pressure and diastolic pressure decreased at T₃ and T₄(P < 0.01), and which at T₅ returned to the levels at T₁ and T₂ in control group(P>0.05).The opening eye time, extubation time and directional force recovery time in observation group were shorter than those in control group(P < 0.01), and the effective rate of anesthesia in observation group(94.00%) was higher than that in control group(80.00%)(P < 0.05).ConclusionsThe general anesthesia combined with epidural anesthesia in hypertension elderly patients treated with laparoscopic cholecystectomy is little effect on hemodynamics and good anesthesia effect, and which is worthy of promotion.