两种全麻药物对表柔吡星化疗后乳腺癌根治术患者QT离散度的影响  

Effects of two different general anesthetics on QT interval dispersion in patients undergoing radical mastectomy after anthracycline chemotherapy

作　　者：范志强[1] 赵光瑜[1] 代冬梅[1] 王忠慧[1] 

机构地区：[1]昆明医学院第三附属医院麻醉科,昆明市650118

出　　处：《临床麻醉学杂志》2010年第10期843-845,共3页Journal of Clinical Anesthesiology

摘　　要：目的比较异氟醚与丙泊酚对表柔吡星化疗后乳腺癌根治术患者QT离散度(QTd)的影响。方法选择ASAⅠ或Ⅱ级,接受表柔吡星化疗或未进行化疗的患者各50例。随机分为AI、AP、CI及CP组,每组25例。AI组与CI组进行1.0%～1.5%异氟醚麻醉,AP组和CP组进行丙泊酚麻醉。记录化疗前(T1)、化疗后2周(T2)、气管插管前(T3)、气管插管后即刻(T4)、全麻给药后5、10、20min(T5～T7)、手术结束停用全麻药物时(T8)及拔除气管导管后10min时(T9)记录QT间期并计算校正的QTd(QTcd)。结果与T1时比较,T2～T9时AI组和AP组QTcd均增加(P<0.05)。T5～T8时AI组QTcd明显高于其他三组(P<0.05)。结论异氟醚可使术前接受表柔吡星化疗的乳腺癌根治术患者QTcd增加,而丙泊酚对此作用不明显。Objective To compare the effects of propofol and isoflurane on QT interval dispersion in patients undergoing radical mastectomy after anthracycline chemotherapy. Methods One hundred patients with ASA physical status I/II undergoing radical mastectomy after anthracyeline chemotherapy or not were randomly divided into four groups with 25 each group： Al, AP, Cl and CP. Anesthesia was maintained with 1.0%-1.5% isoflurane in groups AI and CI, and propofol in groups AP and CP. QT intervals were recorded at prior chemotherapy （T1）, 2 weeks after chemotherapy （T2）, before tracheal intubation （T3）, immediately after tracheal intubation （T4）, 5, 10 and 20 rnin after the drugs delivered （T5-T7）, at the end of surgery （T8） and 10 rain after extubation （T9 3. The adiusted QT interval dispersion （QTcd） was calculated. Results The QTeds at T2 to T9 were significantly increased compared with that at T1 in the groups of AI and AP （P〈0.05）. The QTcds at T5 to T8 in the group AI were far higher than the other three groups （P〈 0. 05）. Conclusion Isoflurane can increase the QTcd in patients who undergoing radial mastectomy after anthracycline chemotherapy, but propofol has no effect on the QTcd.

关 键 词：异氟醚 丙泊酚 乳腺肿瘤 表柔吡星 QT离散度 

分 类 号：R737.9[医药卫生—肿瘤]