摘要
目的探讨术前静脉注射羟乙基淀粉对老年胃癌根治手术患者血流动力学及炎症因子的影响。方法选取该院2011年10月至2013年12月老年胃癌根治手术患者156例,采用随机数字表法分为两组,78例患者术前静脉注射乳酸林格液为对照组,78例患者术前静脉注射羟乙基淀粉为观察组,比较两组患者不同时间点(静脉注射前T0、麻醉后5 min T1、麻醉后30 min T2、麻醉后60 min T3、手术结束时T4)血流动力学指标治疗前后凝血指标(凝血酶原时间、凝血酶时间、部分活化凝血活酶时间)、生化指标〔血红蛋白(Hb)、血细胞比容(Hct)、血小板(Plt)计数〕、炎症因子〔肿瘤坏死因子(TNF)α、干扰素(IFN)γ、白细胞介素(IL)-10〕的改变情况。结果对照组患者心率、平均动脉压在T1时均显著下降,而后逐渐增加;中心静脉压在T1时显著增加,而后逐渐降低。观察组患者心率、平均动脉压在T1、T2、T3、T4时均明显高于对照组,中心静脉压在T1、T2、T3、T4时明显低于对照组。治疗后,两组患者凝血酶原时间、凝血酶时间均显著增加。观察组患者Hb、Hct、Plt、TNFα、IFNγ和IL-10水平均显著降低,Plt、TNFα、IFNγ和IL-10水平均明显低于对照组、部分活化凝血活酶时间明显高于对照组(P<0.05)。结论术前静脉注射羟乙基淀粉有助于稳定老年胃癌根治手术患者的血流动力学指标,显著降低炎症因子水平。
Objective To investigate the effect of hemodynamics and inflammatory factors in elderly patients with gastric cancer radical operation by preoperative intravenous hydroxyethyl starch. Methods 156 elderly patients with gastric cancer radical operation were randomly divided into two groups,78 patients treated with preoperative intravenous injection of ringer lactate solution were as control group,78 patients treated with preoperative intravenous hydroxyethyl starch as observation group. The changes of hemodynamic parameters〔heart rate( HR),mean arterial pressure( MAP),central venous pressure( CVP) 〕at different time points( before intravenous injection T0,after anesthesia 5 min T1,after anesthesia 30 min T2,after anesthesia 60 min T3,at the end of operation T4),the changes of coagulation indexes( prothrombin time; thrombin time; activated partial thromboplastin time); changes of biochemical indexes〔hemoglobin( Hb),hematocrit( Hct),platelet( Plt) count〕; changes of inflammatory cytokines〔TNF-α,interferon( IFN)-γ,interleukin( IL)-10〕were compared between two groups before and after treatment. Results HR and MAP were decreased significantly at T1 and then increased in control group. CVP was increased significantly at T1 and then decreased in control group. HR and MAP at T1,T2,T3,T4 in observation group were significantly higher than those of control group. CVP at T1,T2,T3,T4 in observation group were significantly lower than those of control group. After treatment,prothrombin time and thrombin time were increased significantly in two groups,the levels of Hb,Hct,Plt count,TNFα,IFNγ,IL-10 were decreased significantly in observation group,and they were significantly lower than those of control group. Activated partial thromboplastin time in observation group was significantly higher than that of control group( P<0. 05). Conclusions Preoperative intravenous hydroxyethyl starch is helpful to stabilize hemodynamics of elderly patients with gastric cancer radical operation,which could significantly decrease l
出处
《中国老年学杂志》
CAS
CSCD
北大核心
2015年第20期5808-5810,共3页
Chinese Journal of Gerontology
基金
国家自然青年科学基金项目(81001306)
关键词
羟乙基淀粉
胃癌根治手术
血流动力学
炎症因子
Intravenous injection
Hydroxyethyl starch
Gastric cancer radical operation
Hemodynamics
Inflammatory factor
