全静脉麻醉与静吸复合麻醉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研究  

Effect of different anesthesia methods on pulmonary shunt and oxygenation in elderly patients undergoing laparoscopic radical resection of colorectal cancer

作　　者：陈庆彬 唐璟 苗壮壮 王学军[3] CHEN Qing-bin;TANG Jing;MIAO Zhuang-zhuang;WANG Xue-jun(Department of Anesthesiology,Affiliated Hospital of Qinghai University,810001 Xining,Qinghai,China;Department of Surgery,Affiliated Hospital of Qinghai University,810001 Xining,Qinghai,China;Red Cross Hospital of Qinghai University,810001 Xining,Qinghai,China)

机构地区：[1]青海大学,青海西宁810001 [2]青海大学附属医院,青海西宁810001 [3]青海大学红十字医院,青海西宁810001

出　　处：《临床消化病杂志》2024年第5期351-355,共5页Chinese Journal of Clinical Gastroenterology

基　　金：青海省科技厅2017年度基础研究计划(No.2019-ZJ-758)。

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]选取行腹腔镜下根治术的老年结直肠癌患者96例,按照随机数字表法分为观察组和对照组各48例。对照组采用全静脉麻醉,观察组采用静吸复合麻醉。比较2组患者一般临床资料,记录2组患者插管后15 min(T1时刻)、单肺通气后45 min(T2时刻、)、双肺通气后15 min(T3时刻)肺血分流率(Qs/Qt)及氧合功能指标:血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))的变化情况。[结果]T1时刻,2组患者Qs/Qt值比较,P>0.05;T2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<0.05);T3时刻,2组患者Qs/Qt值较T2时刻恢复(P>0.05)。T1时刻,2组患者SaO_(2)、PaO_(2)水平比较,P>0.05;T2时刻,2组患者SaO_(2)、PaO_(2)水平明显下降,且观察组SaO_(2)、PaO_(2)水平低于对照组(P<0.05);T3时刻,2组患者SaO_(2)、PaO_(2)水平较T2时刻恢复(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]A total of 96 elderly patients with colorectal cancer who underwent laparoscopic radical surgery were selected and divided into observation group and control group according to random number table method,48 cases in each group.The control group was given total intravenous anesthesia,while the observation group was given intravenous inhalation combined anesthesia.The general clinical data of the two groups were compared.The changes of pulmonary blood shunt rate(Qs/Qt)and oxygenation function index(SaO_(2))and arterial partial pressure of oxygen(PaO_(2))were recorded 15 minutes after intubation(T1),45 minutes after one-lung ventilation(T2),15 minutes after two-lung ventilation(T3).[Results]At T1,the Qs/Qt values of the two groups were compared(P>0.05);at T2,the Qs/Qt values of the two groups were significantly increased,and the Qs/Qt values of the observation group were higher than those of the control group(P<0.05);at T3,the Qs/Qt values of the two groups recovered compared with that of the T2 group(P>0.05).At T1,the levels of SaO_(2) and PaO_(2) in the two groups were compared(P>0.05);at T2,the levels of SaO_(2) and PaO_(2) in the two groups decreased significantly,and the levels of SaO_(2) and PaO_(2) in the observation group were lower than those in the control group(P<0.05);at T3,the levels of SaO_(2) and PaO_(2) in the two groups recovered compared with that in the T2 group(P>0.05).[Conclusion]Compared with total intravenous anesthesia,intravenous inhalation combined with anesthesia is more effective in elderly patients undergoing laparoscopic radical resection of colorectal cancer.It can promote the recovery of pulmonary shunt and oxygenation function,and has higher safety.It has certain clinical application value.

关 键 词：老年结直肠癌 全静脉麻醉 静吸复合麻醉 腹腔镜根治术 肺内分流 氧合功能 

分 类 号：R735.35[医药卫生—肿瘤]