摘要
目的 比较吸入麻醉药七氟烷（益君宁）对不同年龄组消化道恶性肿瘤患者血液流变学的影响.方法 选取消化道恶性肿瘤根治手术前的患者中青年组（＜65岁）33例和老年组（≥65岁）29例.诱导麻醉成功后以3％～5％益君宁、0.05～0.2 μg/（kg· min）瑞芬太尼、0.05～0.2 μg/（kg· min）维库溴铵维持麻醉,观察血液流变学、红细胞流变性等指标.结果 麻醉后,2组各个血液黏度指标均下降（P＜0.01或P＜0.05）;T1（MAC达到1～1.3并维持1 h）、T3（进入麻醉恢复室30 min）点2组血浆黏度（ηp）比较有显著差异（P＜0.01或P＜0.05）;T2点（停止吸入麻醉时）2组高切变率全血度Hηb比较有显著性差异（P＜0.01）;红细胞聚集指数（EAI）总体呈现下降趋势;老年组红细胞变形指数（EDI）升高（P＜0.05）,并维持至术后;2组红细胞刚性指数（ERI）都呈下降趋势.结论 围术期七氟烷麻醉能降低消化道恶性肿瘤患者血液流变,能显著降低老年组消化道恶性肿瘤患者的血液黏度.
Objective To observe the influence of sevoflurane anesthesia （Yi J un Ning） on hemorheology in different age patients with gastrointestinal malignancies. Methods A total of 62 ASAⅠ - Ⅱ level patients were divided into older group （≥ 65 years, n = 29） and young group （〈 65 years, n = 33）. Anesthesia was maintained with 3%-5%Yi Jun Ning, 0.05-0.2 μg/（kg· min） remifentanil and 0.05-0.2μg/（kg· min） vecuronium after successful induction of anesthesia. Indicators of hemorheology and erythrocyte rheological were observed. Results After anesthesia, the blood viscosity indexes of both groups declined with different degrees （P 〈 0.01, P 〈 0.05）. The plasma viscosity （ηp） of the 2 groups at point T1 （1-1.3 MAC achieved and maintain for 1 h） and T3 （30 min after entering the anesthesia care unit） differed significantly （P 〈 0.01, P 〈 0.05）. The high shear whole blood viscosity （Hηb） at point T2 （stopping inhalation anesthesia） differed obviously （P〈 0.01）. The erythrocyte aggregation index （EAI） showed a downward trend in both groups. Erythrocyte deformability index （EDI） increased in older group （P 〈 0.05）. Erythrocyte rigidity index （ERI） decreased in both groups. Conclusion Sevoflurane anesthesia can reduce perioperative blood hemorheology in gastrointestinal cancer patients and reduce the blood viscosity in older group.
出处
《实用临床医药杂志》
CAS
2014年第21期67-70,共4页
Journal of Clinical Medicine in Practice
基金
中国高校医学期刊临床专项资金(11321351)
关键词
吸入麻醉
七氟烷
消化道恶性肿瘤
血液流变学
红细胞流变
inhalation anesthesia
sevoflurane
gastrointestinal cancer
hemorheology
erythrocyte rheological
