机构地区:[1]秦皇岛市第一医院肛肠外科,河北秦皇岛066000 [2]河南大学第一附属医院,河南郑州475001
出 处:《临床消化病杂志》2023年第3期227-231,共5页Chinese Journal of Clinical Gastroenterology
基 金:河南省高等学校重点科研项目计划(No:17 A320023)。
摘 要:[目的]探讨不同麻醉方法对老年腹腔镜结直肠癌根治术患者肺内分流及氧合功能的影响。[方法]回顾性分析行腹腔镜下根治术的老年结直肠癌患者96例,其中采用全静脉麻醉48例(对照组)、采用静吸复合麻醉48例(观察组)。比较2组患者一般临床资料,记录2组患者插管后15 min(T_(1)时刻)、单肺通气后45 min(T_(2)时刻、)、双肺通气后15 min(T_(3)时刻)肺血分流率(Qs/Qt)及氧合功能指标;血氧饱和度(SpO_(2))、动脉血氧分压(PaO_(2))的变化情况。[结果]T_(1)时刻,两组患者Qs/Qt值比较无差异(P=0.117);T_(2)时刻,2组患者Qs/Qt值均明显升高,且观察组Qs/Qt值高于对照组(P=0.026);T_(3)时刻,2组患者Qs/Qt值较T_(2)时刻恢复无差异(P=0.140)。T_(1)时刻,2组患者SpO_(2)、PaO_(2)水平比较无差异(均P>0.05);T_(2)时刻,2组患者SpO_(2)、PaO_(2)水平明显下降,且观察组SpO_(2)、PaO_(2)水平低于对照组(均P>0.05);T_(3)时刻,2组患者SpO_(2)、PaO_(2)水平较T_(2)时刻恢复无差异(均P>0.05)。[结论]相比全静脉麻醉,静吸复合麻醉在老年腹腔镜结直肠癌根治术中的效果更佳,能促进肺内分流及氧合功能的恢复,安全性更高,具有一定的临床应用价值。[Objective]To investigate the effects of different anesthesia methods on pulmonary shunt and oxygenation in elderly patients undergoing laparoscopic radical resection of colorectal cancer.[Methods]Forty-eight elderly patients with colorectal cancer who underwent laparoscopic radical resection in our hospital from January 2016to May 2019were analyzed retrospectively.The control group was treated with total intravenous anesthesia and the observation group was treated with intravenous inhalation combined anesthesia.The general clinical data of the two groups were compared,and the changes of pulmonary blood shunt rate(QS/Qt)and oxygenation function indexes:blood oxygen saturation(SpO_(2))and arterial oxygen partial pressure(PaO_(2))were recorded 15min after intubation(T_(1)),45min after one lung ventilation(T_(2)),and 15min after two lung ventilation(T_(3)).[Results]At T_(1)time,there was no difference in QS/Qt between the two groups(P=0.117).At T_(2)time,the QS/Qt value of the two groups increased significantly,and the QS/Qt value of the observation group was higher than that of the control group(P=0.026).At T_(3)time,there was no difference in the recovery of QS/Qt between the two groups compared with T_(2)time(P=0.140).At T_(1)time,there was no difference in SpO_(2)and PaO_(2)levels between the two groups(P>0.05).At T_(2)time,the levels of SpO_(2)and PaO_(2)in the two groups decreased significantly,and the levels of SpO_(2)and PaO_(2)in the observation group were lower than those in the control group(P>0.05);at T_(3)time,there was no difference in the recovery of SpO_(2)and PaO_(2)between the two groups compared with T_(2)time(P>0.05).[Conclusion]Compared with total intravenous anesthesia,intravenous inhalation combined anesthesia shows more effect in elderly laparoscopic radical resection of colorectal cancer,which can promote the recovery of intrapulmonary shunt and oxygenation function,has higher safety.It has certain clinical application value.
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