Objective:To investigate the effect of different anesthetics in inhalation combined with epidural anesthesia on postoperative recovery of patients undergoing partial hepatectomy .Methods :106 patiences underwent partial hepatectomy were randomly divided into control group and observation group .the cases of two groups were treated with inhalation combined with epidural anesthesia ,and were used isoflurane and sevoflurane during inhalation aneathesia respectively .The time of resume spontaneous breathing ,first open eyes ,extubation and recovery direc-tional force was recorded in two groups ;the incidence of complications after waking up in both groups was recorded ;and the scores of MMSE before anesthesia ,2 ,16 and 28 h after surgery were assessed .Results :Compared with the control group ,the time of resume spontaneous breathing ,first open eyes ,extubation and recovery directional force was shorted(P<0 .05) ;the incidence of complications after surgery decreased (P<0 .05) .There was no significant difference of MMSE before anesthesia between two groups (P>0 .05) ,the scores of MMSE decreased 2h after oper-ation in two groups(P<0 .05) ,and the score of MMSE in observation group was significant higher than that in the control group after16h(P<0 .05) .Conclusion :The patiences used isoflurane has higher quality of postoperative re-covery ,and has lower incidence of postoperative complications ,less postoperative intellectual impairment ,aware-ness recovery faster ,and has more advantages compared with epidural anesthesia .%目的:探讨吸入联合硬膜外麻醉中不同麻醉药对肝脏部分切除术患者术后意识恢复的影响.方法:将106例行肝脏部分切除手术患者随机分为对照组和观察组,两组患者均采用吸入联合硬膜外麻醉术,在进行吸入麻醉时分别采用异氟醚和七氟醚.术后记录两组患者恢复自主呼吸、首次睁眼、拔管及恢复定向力所需时间;记录两组患者苏醒后的并发症发生情况,包括恶心呕吐和苏醒期躁动;麻醉前,术后2,16及28 h,测定患者MMSE分值.结果:观察组患者的睁眼时间、拔管时间、定向力恢复时间和自主呼吸时间少于对照组(P<0.05).在术后并发症发生率方面,观察组患者低于对照组(P<0.05).两组患者的术前MMSE分值无统计学差异(P>0.05),术后2 h,两组患者的MMSE分值均明显低于术前(P<0.05),术后16 h,观察组的MMSE分值明显高于对照组(P<0.05).结论:进行七氟醚吸入联合硬膜外麻醉,肝脏部分切除患者术后苏醒质量更高,术后并发症发生率更低,术后智力受损程度更轻,意识恢复更快,与异氟醚吸入联合硬膜外麻醉相比更具优势.
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