丙泊酚与右美托咪定全凭静脉麻醉对食管癌根治术患者肺氧合功能及肺部并发症的影响

发布时间：2018-04-13 16:35

本文选题：食管癌根治术 + 丙泊酚　；参考：《山东医药》2017年05期

【摘要】：目的对比分析丙泊酚与右美托咪定全凭静脉麻醉对食管癌根治术患者围术期肺氧合功能及术后肺部并发症的影响。方法选择择期行经左胸食管癌根治术的患者100例,随机均分为P组、D组,分别使用丙泊酚、右美托咪定行全凭静脉麻醉诱导和维持。记录两组手术相关指标(手术持续时间、术中失血量、补液量、输血量);麻醉前(T_0)、切皮后2 h(T_1)、术后24 h(T_2)分别经桡动脉置管抽动脉血行血气分析,计算氧合指数(OI);记录两组术后2周内肺部并发症发生情况。结果两组手术持续时间、术中失血量、补液量、输血量比较差异无统计学意义(P均0.05)。与T_0时比较,两组T_1、T_2时OI值降低(P均0.05);P组降低更明显(P均0.05)。两组术后2周内肺部并发症发生率比较差异无统计学意义(P0.05)。结论右美托咪定全凭静脉麻醉对食管癌根治术患者氧合功能的改善作用优于丙泊酚;二者对患者术后肺部并发症的影响无差异。
[Abstract]:Objective to compare the effects of total intravenous anesthesia with propofol and dexmetomidine on pulmonary oxygenation function and postoperative pulmonary complications in patients with esophageal cancer undergoing radical resection.Methods 100 patients undergoing radical resection of left thoracic esophageal carcinoma were randomly divided into group P and group D, treated with propofol and dexmetomidine, respectively, for induction and maintenance of total intravenous anesthesia.The operative parameters (duration of operation, intraoperative blood loss, fluid resuscitation, volume of blood transfusion) were recorded in the two groups. Blood gas analysis was performed through radial artery catheterization of arterial blood samples in the two groups before anesthesia, before anesthesia, 2 hours after skin incision, 2 hours after skin incision, and 24 hours after operation.The oxygenation index (Oi) was calculated and pulmonary complications were recorded 2 weeks after operation in both groups.Results there was no significant difference in the duration of operation, the amount of blood loss, the volume of fluid replacement and the amount of blood transfusion between the two groups (P < 0.05).Compared with T _ (0), the decrease of OI in T _ (1) and T _ (2) group was more significant than that in P group (P < 0.05).There was no significant difference in the incidence of pulmonary complications between the two groups within 2 weeks after operation (P 0.05).Conclusion the effect of total intravenous anesthesia of dexmetomidine on the improvement of oxygenation function in patients with esophageal cancer undergoing radical resection is better than that of propofol, and there is no difference between the two groups in postoperative pulmonary complications.
【作者单位】：宜兴市肿瘤医院;宜兴市人民医院;
【基金】：江苏大学临床医学科技发展基金项目(JLY20140070)
【分类号】：R614;R735.1

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