宫颈癌患者术前辅助化疗和不同麻醉方法对血液流变学的影响  

Influences of different anesthesia methods or adjuvant chemotherapy on hemorheological parameters in patients with cervical cancer

作　　者：亢丽艳[1] 王海东[1] 胡青烽[1] 王鸿旻[1] 徐维安[1] 

机构地区：[1]甘肃省肿瘤医院麻醉科,兰州市730050

出　　处：《临床麻醉学杂志》2014年第7期669-671,共3页Journal of Clinical Anesthesiology

基　　金：甘肃省科技厅技术研究与开发专项计划(项目编号:1207TCY035)

摘　　要：目的观察术前辅助化疗宫颈癌患者和不同麻醉方法对其血液流变学的影响。方法选择60例宫颈癌患者,分为A、B两组,每组30例。A组为化疗组,术前接受过三个疗程的化疗;B组为非化疗组,术前未给予化疗。A、B组又随机分为两个亚组,每组15例:A1、B1组行全麻复合硬膜外麻醉;A2、B2组行单纯全麻。所有患者均于麻醉诱导前5min、麻醉诱导后60min、手术结束时分别抽取外周静脉血5ml行血液流变学各项指标的检测。结果与B组比较,术前A组红细胞变形指数(EDI)降低、刚性指数(ERI)及全血粘度升高(P<0.05)。与麻醉诱导前5min比较,麻醉诱导后60min、手术结束时A1、B1组EDI增加,血浆粘度(ηP)、Hct和红细胞聚集指数(EAI)均明显降低(P<0.01);而A2、B2组Hct降低。结论宫颈癌患者术前辅助化疗后存在以红细胞变形力下降为特征的血液流变学变化。全麻复合硬膜外麻醉能明显改善血液流变参数,可为临床提供参考。Objective To observe the influences of different anesthesia methods or adjuvant chemotherapy on hemorheological parameters in patients with cervical cancer.Methods Sixty pa-tients with cervical cancer were equally randomized into two groups.Patients in group A received three courses of chemotherapy preoperatively while those in group B did not.The patients of group A and B were divided respectively into two subgroups,combined epidural general anesthesia group （groups A1 and B1）,general anesthesia group （group A2 and B2）.Blood samples were taken for the hemorheological measurement at 5 min before induction of anesthesia,60 min after induction of anes-thesia and at the end of surgery.Results Red cell deformability index （EDI）was significantly lower in group A than that in group B;Erythrocyte rigidity index （ERI）and blood viscosity were higher in group A compared with those in group B （P 〈0.05）.In groups A1 and B1,EDI,plasmic viscosity packed ERI,and ERI were all lower than those before anesthesia induction （P 〈 0.01 ）;while in groups A2 and B2 Hct decreased.Conclusion The patients of cervical cancer after chemotherapy showed some hemorheological changes characterized by a lowered EDI.Combined general and epidural anesthesia can significantly improve the above parameters.

关 键 词：宫颈癌 辅助化疗 全身麻醉 全麻复合硬膜外麻醉 血液流变学 

分 类 号：R737.33[医药卫生—肿瘤]