结直肠癌根治术患者丙泊酚静脉麻醉期血液流变学及血流动力学变化及意义

目的:探讨结直肠癌根治术中丙泊酚静脉麻醉期患者血液流变学及血流动力学的变化及意义。方法:选择2014年3月-2015年3月我院择期行结直肠癌根治术的90例患者,按照随机数字表法分为实验组(n=45)和对照组(n=45),实验组采用丙泊酚静脉麻醉,对照组采用七氟烷(喜保福宁)吸入麻醉。记录麻醉前(T0)、诱导后90 min(T1)、诱导后150 min(T2)和进麻醉后监测治疗室(PACU)30 min(T3)4个时间点患者血液流变学及血流动力学指标,并进行比较分析。结果:实验组高切变率全血黏度、中切变率全血黏度、低切变率全血黏度在T1、T2和T3时较对照组下降显著(P0.05)。实验组心率(HR)、收缩压(SPB)在T2时均较T0显著下降(P0.05),但T3时又恢复到T0水平(P0.05),实验组和对照组舒张压(DBP)在T1、T2、T3时与T0时比较无显著性差异(P0.05)。结论:丙泊酚静脉麻醉可以降低结直肠癌患者的血液黏度,对患者血液动力学影响较小,是结直肠癌患者手术的理想麻醉药选择。

Changes and Significance of Blood Rheology and Hemodynamics in Patients with Colorectal Cancer during the Period of Propofol Intravenous Anesthesia

ABSTRACT Objective: To investigate the Changes and significance of blood rheology and hemodynamics in patients with colorec- tal cancer during the period of propofol intravenous anesthesia. Methods: According to the stochastic indicator method, 90 patients with colorectal cancer who were treated in our hospital from March 2014 to March 2015 were randomly divided into experimental group (n=45) and the control group (n=45), experimental group was used propofol intravenous anesthesia, control group was anesthetized with seven isoflurane inhalation. The hemorheology and hemodynamics changes were recorded before anesthesia (T0), 90 min after induction of anesthesia (T1), 150 min after induction of anesthesia (T2) and into the PACU 30min (T3), and analysing the results comparatively. Results: The high shear rate of whole blood viscosity, middle shear rate of whole blood viscosity, low shear rate of whole blood viscosity in T1, T2 and T3 were down more significant compared with control group (P<0.05). The HR, SPB of experimental group at T2 de- creased significantly than T0 (P<0.05), but they increased significantly at T3. The DBP at T1, T2 and T3 was no significant difference than T0,both in experimental group and control group (P>0.05). Conclusion: Propofol intravenous anesthesia can reduce the blood vis- cosity in patients with rectal cancer, and it is little effect in hemodynamics. So propofol is an ideal anesthetic choice for rectal cancer surgery.