不同麻醉方式对肺癌根治术患者血流动力学的影响分析

目的：对比分析不同麻醉方式对肺癌根治术患者血流动力学的影响，为肺癌根治术选用理想的麻醉方式提供一定的依据。方法选取行肺癌根治术患者90例为研究对象，随机分为观察组和对照组各45例，观察组行舒芬太尼复合丙泊酚靶控注射，对照组行舒芬太尼静脉恒速注射，丙泊酚靶控输注维持肺癌根治术麻醉。记录麻醉前、切皮后5 min、手术开始30 min、拔管时各时间点的血流动力学指标的变化；记录患者睁眼时间及拔管时间、麻醉镇痛效果，并记录应用麻醉剂后引起的心血管抑制和呼吸抑制等不良反应发生率。结果经研究比较，两组麻醉均可导致患者的收缩压、舒张压降低及HR减慢，与麻醉前相比，切皮后5 min及手术开始30 min后两组血流动力学均发生明显改变，差异具有显著性（P＜0．05）；观察组血流动力学改变较对照组略平稳，组间比较无显著差异（P＞0．05）；观察组睁眼时间及拔管时间均短于对照组，差异具有显著性（P＜0．05）；观察组镇痛有效率高于对照组，差异具有显著性（P＜0．05）。结论舒芬太尼静复合丙泊酚靶控注射用于肺癌根治术患者的手术麻醉，镇痛效果确切，术中血流动力学较为稳定，能够显著缩短睁眼时间及拔管时间，是一种较为理想的麻醉和镇痛方法。

Analysis of Hemodynamic Effects of Different Anesthesia on Lung Cancer Patients Underwent Radical Surgery

Objective To compare hemodynamic effects of different anesthesia on lung cancer patients underwent radical surgery.Methods 90 lung cancer patients underwent radical surgery were randomly divided into the observation group and the control group , 45 cases in each .The observation group was given target controlled infusion with combination of sufentanil and propofol .The control group was given sufentanil intravenous injection with constant velocity .Hemodynamic indexes at different time points ( before anesthesia ,5 minutes after skin cutting ,30 minutes before surgery and extubation ) were recorded .Then the duration of opening eyes ,extubation time ,analgesic effect and the adverse reaction ratio of cardiovasculr depression and respiratory depression were recorded .Results The SBP,DBP and HR decreased in both groups after anesthesia .Compared with before anes-thesia,the hemodynamic indexes 5 minutes after skin cutting or 30 minutes before surgery were changing ,there had statistically significance (P<0.05).The hemodynamic changing of the observation group was more stable than the control group ,there had no statistically significance (P>0.05).The duration of opening eyes and extubation time of the observation group was shorter than the control group,there had statistically significance (P<0.05).The analgesic efficacy of the observation group was higher than the control group,the difference had statistically significance (P<0.05).Conclusion There is a good analgesic efficacy and stable hemodynamic indexes in using target controlled infusion with combination of sufentanil and propofol .And it can greatly reduce the duration of opening eyes and extubation time ,which is an ideal anesthesia and analgesia method .