丙泊酚静脉麻醉对结直肠癌手术患者血液流变学及血流动力学的影响  

Significance and Changes of Hemorheology and Hemodynamics During Propofol Anesthesia in Patients with Colorectal Cancer

作　　者：高红[1] 简丹[1] 苗素琴[1] 吕德珍[1] 陆叶[1] 项阳[2] 

机构地区：[1]南京军区南京总医院麻醉科,江苏南京210009 [2]南京大学,江苏南京210000

出　　处：《河北医学》2015年第3期353-356,共4页Hebei Medicine

基　　金：国家自然科学基金面上项目;(编号:30471991)

摘　　要：目的:探讨丙泊酚静脉麻醉对结直肠癌手术患者血液流变学及血流动力学的影响及意义。方法:将我院择期行结直肠癌根治术的60患者随机分为观察组和对照组,分别采用丙泊酚静脉麻醉和七氟烷吸入麻醉。记录患者麻醉前(T0)、麻醉诱导后90 min(T1)、150 min(T2)以及进入PACU30 min(T3)四个时间点的血液流变学及血流动力学指标。结果:T1、T2和T3三个时间点,观察组患者全血黏度(高切变率、中切变率、低切变率)、血浆黏度及红细胞聚集指数均显著低于对照组,差异具有统计学意义(P<0.05);两组红细胞变形指数无显著差异(P>0.05)。与T0时比较,观察组患者在T2时的HR、SPB显著下降(P<0.05)。两组患者在各时间点的DBP无显著差异(P>0.05)。结论:丙泊酚静脉麻醉用于结直肠癌手术具有良好的效果,不断能够降低患者血液黏度,而且对血流动力学的影响较小。Objective：To investigate the changes of hemorheology and hemodynamics during propofol anesthesia in patients with rectal cancer and analyze their significance .Method： 60 cases of patients with colorectal cancer were randomly divided into the observation group and the control group .The patients in the observation group were acceoted the propofol intravenous anesthesia , while the patients in the control group were gived the sevoflurane inhalation anesthesia .Then the hemorheology and hemodynamics of patients before the anesthesia （T0）, 90 min after induction（T1）, 150 min after induction（T2） and the 30 min later in PACU（T3） were recorded.Result：The high shear rate of whole blood viscosity , middle shear rate of whole blood viscosity , low shear rate of whole blood viscosity , plasma viscosity and erythrocyte aggregation index of observation group in T 1 , T2 and T3 were lower more significant when compared with those of the control group （ P〈0.05）;There was no statistically significant difference about the erythrocyte deformation index at T 1 , T2 and T3 of patients in the two groups（P〉0.05）.The HR and SPB at T2 of patients in the observation group decreased significantly than T 0（P〈0.05）,but there was no statistically significant difference at T 3（P〉0.05）. The DBP at T1, T2 and T3 was no significant difference than T0 in the two groups （P〉0.05）.Conclusion：Propofol intravenous anesthesia can reduce the blood viscosity in patients with rectal cancer ,and it is little effect in hemodynamics .So propofol is an ideal anesthetic choice for rectal cancer surgery .

关 键 词：丙泊酚 血液流变学 血流动力学 结直肠癌 

分 类 号：R614[医药卫生—麻醉学] R735.34[医药卫生—外科学]