不同麻醉方式对急性腹膜炎伴感染性休克患者围麻醉期影响的临床对比研究

目的：探讨不同麻醉方式对急性腹膜炎伴感染性休克患者围麻醉期的影响性，以期提高临床麻醉水平。方法：回顾性分析2011年2月-2012年12月50例急性腹膜炎伴感染性休克患者，对分成2组，对照组予以气管内插管静脉吸入复合全麻组，观察组予以硬膜外阻滞麻醉＋复合全麻组，观察2组麻醉后在各个麻醉循环系数的变化和不良反应情况。结果：两组在入室时在心率、MAP和SpO：比较无明显差异性（P〉0．05），而麻醉后在MAP各个时期以及拔管时在心率上比较有明显差异性（P〈0．05），有统计学意义，SpO2却均在95％以上，比较无差异性（P〉0．05）；在临床效果上，对照组的优良率为60％，总有效率为72％，苏醒时间为（16．5±2．7）min；观察组的优良率为86％，总有效率为100％，苏醒时间为（3．7±1．3）min两组比较有明显的差异性（P〈0．05）；而在不良反应上，在恶心呕吐和呼吸抑制上比较有明显差异性（P〈0．05）；而在疼痛和烦躁上比较无明显差异性（P〉0．05）。结论：硬膜外阻滞麻醉＋复合全麻对急性腹膜炎伴感染性休克患者围麻醉期效果良好．安全性好。

Different Anesthesia Methods on Acute Peritonitis in Patients with Septic Shock Effect Perianesthesia Clinical Comparative Study

Objective： To explore different anesthesia methods on acute peritonitis with septic shock patients perianesthesia impact resistance, in order to improve the level of clinical anesthesia. Methods： A retrospective analysis in February 2011 to December 2012,50 cases of acute peritonitis with septic shock patients, were divided into two groups： the control group received intravenous endotracheal intubation inhalation anesthesia, observation group received epidural resistance anesthesia and anesthesia stagnation, anesthesia anesthesia cycle factor and all the changes and adverse reactions were observed in two groups. Results： The heart rate, MAP and SpO2 burglary in hasno significant difference between two groups （P〉0.05）, while heart rates are more significantly different （P〈0.05） in the MAP various periods after anesthesia and extubation, SpO2 was more than 95%, there was no difference （P〉0.05）; clinical effect, excellent control group was 60%, the total effective rate was 72%, recovery time was （16.5 ± 2.7） min; excellent observation group was 86%, total effective rate was 100%, recovery time was （3.7± 1.3） min, and there was significant difference between two groups （P〈0.05）; in terms of adverse reactions, the nausea vomiting and respiratory depression has relatively significant difference （P〈0.05）; while pain and irritability has no significant difference （P〉0.05）. Conclusion： Epidural anesthesia and anesthesia for patients with acute peritonitis and septic shock perianesthesia have good effect and security.