胃癌患者围术期血液流变性变化的临床研究  

The Changes of Perioperative Hemorheology in Patients with Gastric Cancer

作　　者：谭红平[1] 

机构地区：[1]遂宁市中心医院,四川遂宁629000

出　　处：《现代临床医学》2011年第4期261-263,共3页Journal of Modern Clinical Medicine

摘　　要：目的：探讨胃癌患者麻醉手术期间及术后早期血液流变性的变化。方法：选择ASAⅠ~Ⅱ级行胃癌根治手术的病人30例,年龄40~60岁,在麻醉前、麻醉后30 m in、术毕（麻醉苏醒时）和术后24 h、48 h、72 h分别采肘静脉血,检测Hηb、Lηb、ESR等。结果：与麻醉前比较,麻醉期间血液流变学各指标均降低,其中Hηb、Lηb、ηp、Hct、ESR明显降低;术后早期各血液流变学指标逐渐升高,Hηb、Lηb、ηr、ηp、ESR、EAI至术后72 h时超出正常值范围,ED I在术后24~72 h明显降低。结论：①胃癌患者在麻醉手术前血液黏滞性增高;②麻醉手术期间血液流变性指标降低,血液黏度降低;③术后早期患者全血还原黏度、红细胞聚集指数、全血黏度等血液流变学指标逐渐升高,红细胞变形指数明显降低,对保持微循环灌注和避免术后早期血栓形成十分不利。Objective：To study the changes of hemorheology in patients with gastric cancer during anesthesia and early postoperation.Methods：Selected 30 cases with ASA level Ⅰ to Ⅱ（the age of 40 to 60 years old,patients with gastric cancer of radical surgery）.At the following time points： preanesthesia,30 min after anesthesia,the end of operation,24 h,48 h,72 h after operation,erythrocyte sedimentation rate（ESR）,high shear blood viscosity（Hηb）,low-cut whole blood viscosity（Lηb）,plasma Viscosity（ηp） of the blood in elbow vein were measured.Results：①compared with the health,preanesthesia patient＇s Hηb,Lηb,ηr,ηp and ESR significantly were increased.②During anesthesia,the patient＇sHηb,Lηb,ηr,ηp,Hct,ESR,EAI,ERI were decreased,especially,Hηb,Lηb,ηr,ηp,Hct and ESR were obviously down-regulated.③The early postoperative blood rheology were gradually increased： Hηb,Lηb,ηr,ηp,ESR and EAI exceed the normal range in post-operation 72 h,and EDI from 24 h to 72 h was decreased significantly.Conclusion：①Patients with gastric cancer before operation have a increased markedly blood viscosity.②During anesthesia,hemorheology index and blood viscosity are all decreased.③Patients in early postoperative whole blood viscosity,red cell aggregation index,hemorheology index are gradually increased,erythrocyte deformability index is decreased significantly.witch is too adverse to maintain normal microcirculation and to avoid early postoperative thrombosis.

关 键 词：胃癌 血液流变性 麻醉 围手术期 

分 类 号：R735.2[医药卫生—肿瘤]