不同麻醉方法对腹腔镜子宫切除术患者血清皮质醇及儿茶酚胺的影响

目的：观察不同麻醉方法对腹腔镜子宫切除术患者血清皮质醇及儿茶酚胺的影响。方法：选择行腹腔镜子宫切除术患者42例，随机分为3组：硬膜外麻醉组（A组）、全麻组（B组）、全麻复合硬膜外阻滞组（C组）各14例，于麻醉前10min（T0）、气腹后10min（T1）、气腹后40min（T2）和术后10min（T3）四个时间点，采集静脉血测定皮质醇（COR）和儿茶酚胺（CA）浓度，并观察P旷c02、SP02及血流动力学变化。结果：与T0相比，A组T1时MAP、HR显著下降（P〈0．05），B组T1、T2时MAP、HR、COR和CA明显升高（P〈0．05），C组各时点MAP、HR、COR和CA差异无统计学意义；组间相比，C组各时点MAP、HR、COR和CA显著低于B组（P〈0．05）。结论：全麻复合硬膜外阻滞可以有效地调控腹腔镜子宫切除术患者的应激反应。

Influence of different anesthetic methods on serum cortisone and catecholamines in patients during laparoscopic hysterectomy

Objective： To study the effects of different anesthetic methods on serum cortisone and catecholamines in patients during laparoscopic hysterectomy. Methods： 42 patients scheduled for laparoscopic hysterectomy were randomly divided into three groups： group A （n=14）, group B（n=14） and group C （n=14）. Each group was taken blood samples before anaesthesia,at 10 min and 40 min after pneumoperitomeum with CO2,10 min after operation, to determine the cortisone （COR） and catecholamine（CA）. The changes of MAP, HR, PETCO2 and SPO2 were also recorded. Results： After anesthesia, the MAP, HR significantly decreased in group A （P〈0.05）, the MAP, HR ,COR and CA increased significantly in group B （P〈0.05）, these was no significant difference in the levels ofMAP,HR, COR and CA among all time points in groop C （P 〉0.05）. Conclusion： Combined general epidural anesthesia can effectively inhibit the stress response in patients ondergoing laparoscopic hysterectomy.