摘要
目的 观察乳腺癌患者术前化疗及不同麻醉方法对血液流变学的影响。方法 选择60例乳腺癌患者 ,分为A、B两组 ,每组 3 0例。A组为化疗组 ,术前接受过三个疗程的化疗 ;B组为非化疗组 ,术前未给予化疗。A组又随机分为两个亚组 ,每组 15例 :AⅠ为单纯全麻组 ;AⅡ为全麻复合硬膜外组。所有病例均于麻醉前、A组再于麻醉后 1小时各抽取外周静脉血 5ml置入密封试管中送做各项血液流变学指标检测。结果 A组麻醉前红细胞变形指数降低 ,刚性指数及全血粘度升高 ,与B组相比有显著差异 (P <0 0 5 )。AⅡ组 ,红细胞变形指数增加 ,全血粘度、血浆粘度、红细胞压积和红细胞聚集指数均较麻醉前下降 (P <0 0 1) ;而AⅠ组只有全血粘度、红细胞压积降低。结论 乳腺癌患者术前化疗后存在与红细胞变形力下降为特征的血液流变学变化。全麻复合硬膜外麻醉能明显改善血液流变 。
Objective To observe the hemorheological changes in patients with breast cancer after chemotherapy.Methods Sixty patients with breast cancer were divided randomly into two groups with 30 cases each.The patients in group A were received three courses of chemotherapy preoperatively and those of group B were not.The patients of group A were subdivided randomly into two subgroups.General anesthesia was used in group AⅠ and combined epidural general anesthesia in group AⅡ.Blood samples from all patients were taken before induction of anesthesia,and another blood samples from the patients of group A were also taken at one after anesthesia for the hemorheological measurements.Results Red cell deformability (RCD) was lower mardedly in group A than that in group B:RBC rigidity and blood viscosity were higher in group A compared with those in group B ( P< 0 05).In group AⅡ RCD,blood viscosity,plasmic viscosity packed RBC volume,and RBC aggregation index were all lower at one after anesthesia than those before ( P< 0 01).Conclusions The patients of breast cancer after chemotherapy exist some hemorheological changes characterized by a lowered RCD.Combined epidural general anesthesia might improve the hemorheological conditions and could be a better anesthetic choice for those patients.
出处
《临床麻醉学杂志》
CAS
CSCD
2002年第3期124-126,共3页
Journal of Clinical Anesthesiology
