摘要
目的观察丙泊酚静脉麻醉对老年直肠癌患者血液流变学的影响。方法选择2014年1月至2015年1月我院收治的80例ASA分级为I-II级的择期行直肠癌根治术患者,将80例患者随机分为A、B两组,两组患者手术时均使用咪达唑仑0.1 mg/Kg,丙泊酚1.5 mg/Kg,瑞芬太尼0.2μg/(Kg·min)和维库溴铵0.03 mg/Kg进行麻醉诱导,术中分别静脉持续泵注丙泊酚4 mg/(Kg·h)、8 mg/(Kg·h)。患者在手术前均行颈内静脉穿刺,于麻醉前(T_0)、切皮后60 min(T_1)、120 min(T_2)、进入PACU 30 min(T_3)后抽取中心静脉血各10 m L检测T_0、T_1、T_2、T_3时间点的全血黏度(高切、中切、低切)、血浆黏度、红细胞聚集指数、红细胞变形指数,并对结果进行组内、组间分析。结果 A组内比较全血高、中、低切黏度,血浆黏度及红细胞聚集指数,在T_1、T_2、T_3时均比T_0有明显下降(P<0.05);B组内比较全血高、低切黏度,血浆黏度及红细胞聚集指数,在T_2、T_3时均比T_0有明显下降(P<0.05),而全血中切黏度T_3比T_0有明显下降(P<0.05);A组与B组相比,A组患者的全血高、中、低切黏度,血浆黏度,红细胞聚集指数均低于B组(P<0.05);而全血红细胞变形指数不管组内比较还是组间比较,各时间点均无显著差异(P>0.05)。结论手术中持续泵入丙泊酚4 mg/(Kg·h)可以有效的降低术中全血黏度、血浆黏度、红细胞聚集指数,可以有效降低手术过程中的风险。
Objective To observe the effect of propofol intravenous anesthesia on blood rheology in elderly pa- tients with rectal cancerr. Methods 80 cases （ ASA Ⅰ-Ⅱ） radical resection of rectal cancer in our hospital from January 2014 to January 2015 , 80 cases were randomly divided into two groups： group A and group B, the two groups of patients treated with midazolam 0.1mg/kg, propofol 1.5mg/kg. Remifentanil 0.2 g / kg / min） and vecuronium 0.03mg/kg for induction of anesthesia, intraoperative respectively continuous intravenous infusion of propofol 4mg/（kg·h）,Smg/（kg·h）. Patients was performed in internal jugular vein puncture, the before anesthesia （To）, after skin incision （T1） for 60 min, 120 min （T2）, enter the PACU 30 min （T3） after extraction of center venous blood 10ml detection T0, T1, T2 and T3 time points of whole blood viscosity （high shear, shear, low shear）, plasma viscosity, erythrocyte aggregation index, erythrocyte deformation index were recorded ,and the results were analyzed. Results In A group the high, middle and low shear whole blood viscosity, plasma viscosity and erythrocyte aggregation index in T1, T2, T3 were significantly lower than To （P〈0.05）; In B group, the high, middle and low shear whole blood viscosity, plasma viscosity and erythrocyte aggregation index in T2, T3 were significantly lower than To （P〈0.05）, and middle shear blood viscosity OF T3 was lower than To （P〈0.05） ; A group compared with B group, A group whole blood high and low shear viscosity, plasma viscosity, erythrocyte aggregation index, was lower than B group （P〈0.05） . Red blood cell deformability index had no significant differences at each time point compared with before （P〉0.05）. Conclusion： Intraoperative sustained pumping propofol 4mg / kg （-H） can effectively reduce intraoperative blood viscosity, plasma viscosity, erythrocyte aggregation index,it can effectively reduce the risk in the process of operation.
出处
《结直肠肛门外科》
2016年第3期295-299,共5页
Journal of Colorectal & Anal Surgery
