摘要
Abstract
Objective:To explore the clinical effect of general anesthesia combined with epidural anesthesia on elderly hypertensive patients undergoing laparoscopic cholecystectomy.Method:A total of 88 elderly patients with hypertension undergoing laparoscopic cholecystectomy who were hospitalized in Jiujiang Chaisang District People's Hospital from January 2018 to October 2022 were selected as the study subjects.According to the random number table method,there were 44 cases in the control group(simple general anesthesia group)and 44 cases in the case group(general anesthesia combined with epidural anesthesia group).The postoperative effects of patients and the effects on nerve function and inflammatory factors were observed.Result:The recovery time of spontaneous respiration,the time of complete awakening and the time of extubation in the case group were shorter than those in the control group(P<0.05).Compared with those before anesthesia(T1),the levels of SBP,DBP and HR during intubation(T2),during operation(T3)and after extubation(T4)were significantly higher in the two groups,the levels of SBP,DBP and HR in the case group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).Postoperative 2 and 24 hours,the whole blood low shear viscosity,whole blood high shear viscosity,HCT,plasma viscosity,IL-6,IL-8,TNF-α and CRP levels in the two groups were significantly lower than those before anesthesia,the improvement of hemorheology indexes and serum inflammatory factors in the case group were significantly better than those in the control group at 2 hours and 24 hours after operation,the differences were statistically significant(P<0.05).24 hours after surgery,the scores of NIHSS and NFDS in the two groups were lower than those before treatment,the improvement of the neurological function scale in the case group were better than those in the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the case group was lower than that in the control group(4.55%vs.13.64%),but the difference was not statistically significant(P>0.05).Conclusion:General anesthesia combined with epidural anesthesia has a significant effect on elderly hypertensive patients undergoing laparoscopic cholecystectomy.It can improve hemodynamics,promote the recovery of brain nerve function,reduce the stimulation of inflammatory factors,and has high safety.关键词
全身麻醉/硬膜外麻醉/腹腔镜胆囊切除术/血流动力学/神经功能/炎症因子Key words
General anesthesia/Epidural anesthesia/Laparoscopic cholecystectomy/Hemodynamics/Nerve function/Inflammatory factor
