靜脈輸注利多卡因對腹腔鏡膽囊切除術快速康復的臨床價值

高志方

[摘要] 目的 探討靜脈輸注利多卡因對腹腔鏡膽囊切除術患者快速康復的影響。 方法 選取本院2012年10月～2016年10月腹腔鏡膽囊切除術患者182例，采用隨機數字表法分為兩組，對照組患者91例在麻醉誘導前靜脈輸注生理鹽水1 mg/kg，觀察組患者91例在麻醉誘導前靜脈輸注利多卡因1 mg/kg，比較兩組手術指征、術后恢復情況、生活質量、并發癥。 結果 兩組患者治療后SAS評分與SDS評分較治療前降低，而治療后生活質量評分較治療前增加（P<0.05）。觀察組患者治療后SAS評分、SDS評分、并發癥發生率低于對照組，生活質量評分高于對照組，術后意識恢復時間、術后拔管時間、下床活動時間、術后排氣時間、術后排便時間早于對照組，術后止痛時間、術后住院時間少于對照組（P<0.05）。 結論 靜脈輸注利多卡因有助于加快腹腔鏡膽囊切除術患者的術后康復進程，并改善其心理狀況，提高其生活質量和安全性，值得臨床推廣使用。

[關鍵詞] 靜脈輸注；利多卡因；腹腔鏡膽囊切除術；臨床價值

[中圖分類號] R614 [文獻標識碼] B [文章編號] 1673-9701（2018）19-0123-03

Clinical value of intravenous lidocaine for rapid recovery of laparoscopic cholecystectomy

GAO Zhifang

Department of Anesthesiology，Liaocheng Traditional Chinese Medicine Hospital in Shandong Province，Liaocheng 252000，China

[Abstract] Objective To investigate the effect of intravenous injection of lidocaine on rapid recovery of patients undergoing laparoscopic cholecystectomy. Methods 182 patients undergoing laparoscopic cholecystectomy in our hospital from October 2012 to October 2016 were selected and divided into two groups according to a random number table. 91 patients in the control group received intravenous injection of 1 mg/kg saline before anesthesia induction， 91 patients in the observation group received intravenous injection of 1 mg/kg lidocaine before anesthesia induction. The operation indications， postoperative recovery， quality of life and complications of the two groups were compared. Results SAS and SDS scores decreased in both groups after treatment， while the quality of life scores were higher than those before treatment（P<0.05）. SAS and SDS scores were lower and the quality of life score was higher in the observation group than those in the control group after treatment. The postoperative time of consciousness recovery， extubation， off-bed activity， exhaust and defecation in the observation group were earlier than the control group， the postoperative duration of analgesia and hospitalization were less than the control group（P<0.05）. Conclusion Intravenous injection of lidocaine helps to accelerate the postoperative recovery of patients undergoing laparoscopic cholecystectomy， improve their psychological status， quality of life and safety， which is worthy of clinical promotion.

[Key words] Intravenous injection；Lidocaine；Laparoscopic cholecystectomy；Clinical value

腹腔鏡膽囊切除術是臨床常用術式，術中需要建立氣腹，會對患者呼吸循環系統和神經內分泌系統造成不同程度的影響，將增加患者的手術風險和術中管理難度，也不利于患者的術后快速恢復[1-2]。如何改善患者的預后，提高術后恢復進程，一直是臨床醫生爭論的焦點。利多卡因是一種酰胺類局部麻醉藥物，給予患者靜脈輸注利多卡因，可起到保護臟器，發揮鎮痛、抗炎的作用，效果顯著[3-4]，但對腹腔鏡膽囊切除術患者快速康復的影響相關報道少見，本文旨在探討靜脈輸注利多卡因對腹腔鏡膽囊切除術患者快速康復的影響，現報道如下。

1 資料與方法

1.1 一般資料

本院2012年10月～2016年10月腹腔鏡膽囊切除術患者182例，入選標準：年齡≥18歲，ASA分期Ⅰ～Ⅱ級。排除標準：患有心動過緩、肝腎功能異常、神經系統疾病、內分泌系統疾病、藥物過敏、研究資料不全者。采用隨機數字表法分為兩組，對照組患者91例，男49例，女42例，年齡為25～67（48.5±10.3）歲，病因：膽囊結石21例、急性膽囊炎31例、膽囊息肉28例、膽囊穿孔11例。……