小剂量呋塞米联合呼气末正压在老年食管癌根治术中的应用效果

发布时间：2018-04-14 05:15

本文选题：呋塞米 + 呼气末正压　；参考：《实用临床医药杂志》2016年23期

【摘要】：目的观察小剂量呋塞米联合呼气末正压(PEEP)对老年食管癌根治术患者血流动力学和氧合的影响。方法择期全身麻醉下行食管癌根治术患者33例,随机分为呋塞米组(A组)、呋塞米+PEEP组(B组)和对照组(C组)。缝合膈肌时A组给予呋塞米0.2 mg/kg,B组给予呋塞米0.2 mg/kg并将PEEP调至5 cm H_2O。观察各组麻醉前(T_0)、麻醉诱导插管(T1)、拔管后即刻(T_2)及拔管后15 min(T_3)的心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)和氧合指数[p(O_2)/FiO_2]的变化。结果 A组和B组的拔管时间显著短于C组(P0.05)。C组在T_2、T_3时的CVP显著高于A组和B组(P0.05)。A组和B组的p(O_2)/FiO_2在T2、T3时显著高于C组(P0.05),而B组的p(O_2)/FiO_2在T_2、T_3时又显著高于A组(P0.05)。结论小剂量呋塞米联合使用PEEP可改善老年食管癌根治术患者的氧合情况,缩短拔管时间。
[Abstract]:Objective to observe the effects of low dose furosemide combined with positive end-expiratory pressure (PEEP) on hemodynamics and oxygenation in elderly patients with esophageal cancer undergoing radical resection.Methods Thirty-three patients undergoing radical resection of esophageal carcinoma under selective general anesthesia were randomly divided into two groups: group A (furosemide group), group B (furosemide PEEP group) and group C (control group).Group A was treated with furosemide 0.2 mg / kg and group B was given furosemide 0.2 mg/kg and PEEP was adjusted to 5 cm H _ 2O.The changes of heart rate, mean arterial pressure, central venous pressure and oxygenation index (p(O_2)/FiO_2) were observed before anesthesia, anesthesia induction intubation (T _ 1), immediately after extubation (T _ (2)) and 15 min after extubation (T _ (3)).Results the extubation time of group A and group B was significantly shorter than that of group C (P 0.05). The CVP of group C was significantly higher than that of group A and group B at T _ 2T _ 3, and the p(O_2)/FiO_2 of group A and B was significantly higher than that of group C at T _ 2T _ 3, and the p(O_2)/FiO_2 of group B was significantly higher than that of group A at T _ 2T _ 3.Conclusion low dose furosemide combined with PEEP can improve oxygenation and shorten extubation time in elderly patients with esophageal cancer.
【作者单位】：江苏省扬州市第一人民医院麻醉科;
【分类号】：R735.1

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