發(fā)布時間：2018-05-06 05:10

  本文選題：七氟烷 + 麻醉　； 參考：《中國老年學雜志》2016年16期

【摘要】：目的探討七氟烷吸入聯(lián)合硬膜外麻醉在老年消化道惡性腫瘤切除術(shù)中的臨床效果。方法 74例接受消化道惡性腫瘤切除術(shù)的老年患者,按麻醉方式不同分為單純麻醉組35例和聯(lián)合麻醉組39例,記錄各手術(shù)時間點腦電雙頻指數(shù)(BIs)、吸入氣濃度(Fi)和呼出氣濃度(Et),氣管插管后5 min(T0)、單肺通氣開始時(T1)、單肺通氣后30 min(T2)、60 min(T3)、90 min(T4)、恢復(fù)雙肺通氣時(T5)、恢復(fù)雙肺通氣后10 min(T6)及手術(shù)結(jié)束時(T7)分別監(jiān)測患者心率(HR)、收縮壓(SBP)和舒張壓(DBP);麻醉前和麻醉后24 h測定白細胞PK與G6PD活性;手術(shù)前后采用簡易精神狀態(tài)評價量表(MMSE)對兩組患者認知功能進行評分。結(jié)果聯(lián)合麻醉組患者的HR、SBP和DBP波動顯著小于單純麻醉組,尤在T1和T5時,單純麻醉組變化最明顯(P0.05)。麻醉后24 h兩組白細胞PK和G6PD活性較麻醉前明顯升高,且聯(lián)合麻醉組明顯高于單純麻醉組(P0.05);單純麻醉組麻醉恢復(fù)時、術(shù)后1、3、7 d的MMSE評分均顯著低于聯(lián)合麻醉組(P0.05)。結(jié)論七氟烷吸入聯(lián)合硬膜外麻醉能達到滿意的臨床麻醉深度和效果,且有利于保護患者的心肺功能、改善術(shù)后認知功能障礙。
[Abstract]:Objective to investigate the clinical effect of sevoflurane inhalation combined with epidural anesthesia in the resection of digestive tract malignant tumors in the elderly. Methods 74 elderly patients undergoing resection of malignant tumors of digestive tract were divided into simple anesthesia group (35 cases) and combined anesthesia group (39 cases) according to different anesthetic methods. EEG bispectral index (BIsa), inhaled gas concentration (Fig) and exhaled air concentration (Etl) were recorded at each operating time point, 5 min after endotracheal intubation, 5 min after endotracheal intubation, 30 min after single lung ventilation, 60 min T3 + 90 min T4, 10 min after restoration of bipulmonary ventilation, 10 min after T6) and 30 min after single lung ventilation. At the end of operation, T7) was used to monitor heart rate, systolic blood pressure (SBP) and diastolic blood pressure (DBP) respectively, and to detect leukocyte competition and G6PD activity before anesthesia and 24 hours after anesthesia. The cognitive function was evaluated by MMSE before and after operation. Results the fluctuation of HRP and DBP in the combined anesthesia group was significantly lower than that in the simple anesthesia group, especially at T1 and T5. WBC competition and G6PD activity in the two groups were significantly higher than those before anesthesia 24 h after anesthesia, and the MMSE scores of the combined anesthesia group were significantly lower than those of the combined anesthesia group on the 1st and 7th day after anesthesia recovery, and were significantly higher in the combined anesthesia group than in the simple anesthesia group. Conclusion sevoflurane inhalation combined with epidural anesthesia can achieve satisfactory clinical anesthetic depth and effect, and can protect patients' cardiopulmonary function and improve postoperative cognitive dysfunction.
【作者單位】： 解放軍117醫(yī)院麻醉科;
【分類號】：R614;R735

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本文編號：1850920