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目的:探讨结直肠癌根治术中丙泊酚静脉麻醉期患者血液流变学及血流动力学的变化及意义。方法:选择2014年3月-2015年3月我院择期行结直肠癌根治术的90例患者,按照随机数字表法分为实验组(n=45)和对照组(n=45),实验组采用丙泊酚静脉麻醉,对照组采用七氟烷(喜保福宁)吸入麻醉。记录麻醉前(T0)、诱导后90 min(T1)、诱导后150 min(T2)和进麻醉后监测治疗室(PACU)30 min(T3)4个时间点患者血液流变学及血流动力学指标,并进行比较分析。结果:实验组高切变率全血黏度、中切变率全血黏度、低切变率全血黏度在T1、T2和T3时较对照组下降显著(P<0.05)。实验组心率(HR)、收缩压(SPB)在T2时均较T0显著下降(P<0.05),但T3时又恢复到T0水平(P>0.05),实验组和对照组舒张压(DBP)在T1、T2、T3时与T0时比较无显著性差异(P>0.05)。结论:丙泊酚静脉麻醉可以降低结直肠癌患者的血液黏度,对患者血液动力学影响较小,是结直肠癌患者手术的理想麻醉药选择。
Objective: To investigate the changes and significance of hemorheology and hemodynamics in patients undergoing propofol anesthesia during radical resection of colorectal cancer. Methods: From March 2014 to March 2015, 90 patients undergoing radical resection of colorectal cancer in our hospital were randomly divided into experimental group (n = 45) and control group (n = 45) Group received propofol intravenous anesthesia, the control group sevoflurane (hi Baofu Ning) inhalation anesthesia. The hemorheology and hemodynamics were recorded at 4 time points before anesthesia (T0), 90 min after induction (T1), 150 min after induction (T2) and 30 min after PACU (T3) Learning indicators, and comparative analysis. Results: The high shear rate whole blood viscosity, the middle shear rate whole blood viscosity and the low shear rate whole blood viscosity decreased significantly at T1, T2 and T3 compared with the control group (P <0.05). Heart rate (HR) and systolic blood pressure (SPB) in experimental group decreased significantly compared with T0 at T2 (P <0.05), but returned to T0 at T3 (P> 0.05) There was no significant difference at T1, T2, T3 and T0 (P> 0.05). Conclusion: Intravenous propofol anesthesia can reduce the blood viscosity of patients with colorectal cancer, hemodynamic less impact on patients with colorectal cancer surgery is the ideal choice of anesthetic.