不同麻醉方式对于乳腺癌改良根治术患者PONV症状的影响分析

摘要

目的：研究硬膜外麻醉（Epidural space block anesthesia，ESBA）、静脉全麻（Total intravenous anesthesia，TIVA），以及吸入全麻（ Inhalational anesthesia ，IA）对于乳腺癌改良根治术患者PONV（ Postoperative nausea and vomiting ，术后恶心、呕吐）症状的影响分析。方法选择2012－01～2013－12间在我院治疗的乳腺癌患者163例作为研究对象，患者均接受改良根治术。其中接受硬膜外麻醉者56例，归入硬膜外麻醉组；接受静脉全麻者54例，归入静脉全麻组；接受吸入全麻者53例，归入吸入全麻组。统计并对比各组患者DBP、SBP及MAP水平，PONV症状情况以及患者麻醉时间、手术时间及PONV症状缓解时间。结果采用不同麻醉方式进行手术的前后，患者DBP、SBP及MAP水平差异均无统计学意义（均P＞0.05）。三组不同麻醉方式均可产生PONV症状，其中吸入全麻组和静脉全麻组的恶心、呕吐占比均显著高于硬膜外麻醉组，差异均有统计学意义（均P＜0.05）。但吸入全麻组和静脉全麻组之间的差异无统计学意义（P＞0.05）。三组的麻醉时间和手术时间相比，差异无统计学意义（P＞0.05），但静脉全麻组和吸入全麻组的PONV症状缓解时间显著多于硬膜外麻醉组，差异有统计学意义（ P＜0.05）。而静脉全麻组和吸入全麻组间相比，差异无统计学意义（ P＞0.05）。结论不同麻醉方式对于乳腺癌根治术患者产生PONV症状的影响程度不同，但硬膜外麻醉产生的PONV发生率较低。%Objective To study impact analysis of PONV symptoms of epidural space block anesthesia ( ESBA ) , total intravenous anesthesia ( TIVA) and inhalational anesthesia ( IA) for breast cancer patients undergoing modified radical operation.Methods Selecting 163 cases from January, 2012 to December, 2013 in the hospital, who were treated with modified radical mastectomy.56 patients received epidural space block anesthesia as ESBA group;54 patients received total intravenous anesthesia as TIVA group;53 patients received inha-lational anesthesia as IA group.Statistical comparison of DBP , SBP and MAP levels , PONV symptoms as well as anesthesia time , surgery time and time PONV symptoms of patients in each group were compared.Results After using different anesthesia methods for surgery , the patients′DBP, SBP and MAP levels were not statistically significant (P>0.05).Three different anesthetic methods could produce PONV symptoms In, TIVA group and IA group , nausea and vomiting were significantly higher than TIVA group , TIVA and IA group′s difference was not statistically significant ( P>0.05 ).For anesthesia and surgery time , the difference was not statistically significant among three groups ( P>0.05 ) , but TIVA group and IA group′s PONV symptoms were significantly more than the ease of ESBA group , and the differ-ence was statistically significance ( P<0.05 ).For TIVA group and IA group , the difference was not statistically significant ( P>0.05 ).Conclusion Different anesthesia methods for radical mastectomy patients have varying degrees of impact on PONV symptoms , but lower in-cidence of PONV epidural anesthesia occurs.