目的：初步探讨基于快速康复理念下腹腔镜胆囊切除手术患者麻醉管理方案的作用。方法将38例拟行腹腔镜胆囊切除手术患者按随机数字法分为两组，各19例。试验组：采用联合麻醉，全身麻醉+硬膜外阻滞麻醉；对照组：常规全身麻醉，测定并比较两组患者行麻醉前、气腹成功时、手术开始15min时及术毕时的血糖、血清皮质醇浓度水平，并记录术后苏醒时间、排气时间及相关不良反应等指标。结果对照组患者在各时间点的血清皮质醇浓度水平较麻醉前均变化明显，且显著高于试验组患者同时间点的水平（P<0.05），各时间点的血糖变化类似于血清皮质醇浓度（P<0.05）；相比对照组患者，试验组患者术后排气时间提前，住院时间缩短（P<0.05），且两组相关不良反应的差异有统计学意义（P<0.05）。结论快速康复理念指导下麻醉管理能够有效减轻腹腔镜胆囊切除手术患者的应激反应，加速快速康复。%Objective To investigate the effect of anesthesia management of patients with laparoscopic cholecystectomy(LC) based on fast track surgery(FTS). Methods A randomized controlled clinical trial was carried out, 38 patients were randomly divided into test group(n=19,epidural block anesthesia and general anesthesia) and control group (n=19,general anesthesia). The blood glucose(Glu)and serum cortisol were tested at the following four time pointsbefore anesthesia, at pneumoperitoneum, 15 min after surgery and completing operation. Awakening time, evacuation time post operation and adverse events were observed and compared. Results Compared with before anesthesia, serum cor-tisol and Glu were increased at various time point in control group (P<0.05), there were statistical differences in two groups (P<0.05). Awakening time and evacuation time post operation of test group were earlier than control group (P<0.05). There were statistical differences in adverse events post operation in two groups(P<0.05). Conclusion Anesthesia management based on FTS can decrease stress reaction and accelerate rapid rehabilitation for patients of LC.
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