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肝癌微波凝固治疗的麻醉

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摘要 目的总结2004年1月至2006年12月,用UMC-1超声引导微波凝固治疗仪,治疗肝癌183例,用不同麻醉方法治疗,探讨对全身不同的影响。方法选择肝癌肿瘤患者183例,ASAⅡ~Ⅲ级,年龄33~78岁。随机分为两组,A组:选择硬膜外麻醉118例,T8.9穿刺成功后用2%利多卡因5ml,5分钟后麻醉平面T4—T10,用0.375%罗派卡因维持麻醉,辅助少量杜氟1.5ml镇静,减少应激反应。B组:65例选择静脉全麻+局部麻醉,治疗时用2%利多卡因5-10ml局部麻醉,丙泊酚0.05-1mg/kg/h,杜氟1.5ml静注,病人入睡后即可开始手术治疗。结果两组病人术中生命体征均正常。A组病人能很好配合医生治疗,术后也便于安装止痛泵止痛。B组病人麻醉后不能很好配合医生治疗,术后因肝包膜胀痛,需立即行止痛治疗,老人及体质差的病人循环和呼吸影响较大。结论肝癌用UMC-I微波凝固治疗仪治疗时,只要无硬膜外禁忌症前提下,麻醉医生熟练操作,选择硬外麻醉明显优于静脉麻醉,麻醉费用也较低廉,术中也便于麻醉管理。
作者 黄运伯
出处 《海南医学》 CAS 2007年第9期102-103,共2页 Hainan Medical Journal
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