不同麻醉方式對(duì)急性腹膜炎伴感染性休克患者圍麻醉期的影響.pdf

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1、·1328·中華醫(yī)院感染學(xué)雜志2013年第23卷第6期ChinJNosocomiolVo1．23No．62013·論著·不同麻醉方式對(duì)急性腹膜炎伴感染性休克患者圍麻醉期的影響吳風(fēng)罡(浙江省腫瘤醫(yī)院麻醉科，浙江杭州310000)摘要：目的探討氣管內(nèi)插管靜吸復(fù)合全麻與硬膜外阻滯+復(fù)合全麻兩種不同麻醉方式對(duì)急性腹膜炎合并感染性休克患者圍麻醉期的影響。方法選擇急性腹膜炎合并感染性休克患者37例，隨機(jī)分為氣管內(nèi)插管靜吸復(fù)合全麻組(靜吸組)17例、硬膜外阻滯+復(fù)合全麻組(阻滯組)20例，分別觀察兩組在各個(gè)麻醉時(shí)期循環(huán)系數(shù)的變化及不良反應(yīng)發(fā)生情況。結(jié)果入室時(shí)兩組心

2、率、動(dòng)脈平均壓(MAP)及血氧飽和度(SpOz)差異均無統(tǒng)計(jì)學(xué)意義；進(jìn)入麻醉誘導(dǎo)期，兩組心率明顯下降，SpO仍能維持于99；拔管時(shí)，靜吸組心率高于阻滯組(P

3、rianesthesia0fpatientscomplicatedwithacuteperitonitisandsepticshockWuFeng—gang(ZejiangProvincialTumorHospital，Hangzhou，Z^ejiang310000，China)Abstract：OBJECTIVETodiscusstheeffectsofintratrachealgeneralanesthesiaandgeneralanesthesiacombinedwithepiduralblockontheperianesthesiaofthe

4、patientswithacuteperitonitiscombinedwithsepticshock．METHODSAtotalof37patientswithacuteperitonitiscombinedwithsepticshockwereselectedandwererandomlydividedintotheintratrachealgeneralanesthesiagroup(thecontrolgroup)with17casesandthegeneralanesthesiacombinedwithepiduralblock(theco

5、mbinationgroup)with20cases．Thechangesofcirculatingcoefficientandtheincidenceofadversereactionsinvariousperiodsofanesthesiawereobserved．RESULTSThedifferenceintheheartrate，meanarterypressure(MAP)，ortheOxygensaturation(SpO2)betweenthetWOgroupswasnotstatisticallysignificant．Inthein

6、ductionofanesthesia，theheartratesofbothgroupsweresignificantlydecreased，Sp02remained99．Atthemomentofextubation，theheartrateofthecontrolgroupwashigherthanthatofthecombinationgroup(P<0．05)．Invariousperiodsofanesthesia，theMAPofthecontrolgroupwashigherthanthatofthecombinationgroup．

7、Thecombinationgrouphadabetteranestheticeffectandlessadversereactionthandidthecontrolgroup．CONCLUSIONThegeneralanesthesiacombinedwithepiduralblockcanachievebetteranestheticeffectintheemergencysurgeryfortheacuteperitonitiscomplicatedwithsepticshock，whichisworthytobepromoted．Keywo

8、rds：Acuteperitonitis；Septicshock；Anesthesiaapproach；Pe