七氟醚麻醉在冠心病胃癌患者内镜黏膜下剥离术中的应用效果及对心功能的影响

目的 探讨七氟醚麻醉应用于冠心病胃癌患者内镜黏膜下剥离术的有效性及对心功能指标的影响.方法 选取冠心病胃癌患者66例,依据麻醉方法平均分为对照组和观察组.对照组应用芬大尼和维库溴铵麻醉,观察组在对照组基础上静脉持续性吸入七氟醚.2组均行内镜黏膜下剥离术(ESD)治疗.比较2组手术时间、术中失血量、中心静脉压(cvP)、血氧饱和度(SpO2)、心率(HR)及术后6d镇静和疼痛评分.检测2组血清白细胞介素6(IL-6)、IL-8、肿瘤坏死因子(TNF-α)水平以及心功能指标舒张早期/舒张晚期最大血流速度(E/A)值和左心室射血分数(LVEF).结果 观察组患者的手术时间、术中失血量、CVP、SpO2、HR以及术后6d的Ransay和VAS评分与对照组比较,差异均无统计学意义(P＞0.05).术后1d,观察组患者血清IL-6、IL-8和TNF-c水平分别低于对照组,而LVEF和E/A明显高于对照组,差异有统计学意义(P＜0.01).结论 冠心病胃癌患者内镜黏膜下剥离术中应用七氟醚麻醉效果良好,且发挥了较好心功能保护作用.

Effect of Sevoflurane Anesthesia in Endoscopic Submucosal Dissection for Gastric Cancer and Its Influence on Heart Function

Objective To investigate the effect of sevoflurane anesthesia for patients with gastric cancer in endoscopic submucosal dissection and influence on heart function.Methods 66 patients with gastric cancer were averagely divided into the control group and the observation group by different anesthesia methods.The control group was carried out a general anaesthetic of vecuronium bromide and fentanyl anesthesia.Based on the control group,the observation group was with continuity suction of sevoflurane.The 2 groups was treated with endoscopic submucosal dissection.Time of operation,intraoperative blood loss,CVP,SpO2,HR,and scores of Ransay and VAS were observed in the 2 groups.Serum levels of IL-6,IL-8,TNF-α,and E/A and LVEF were detected in both groups.Rerults Comparison time of operation,intraoperative blood loss,CVP,SpO2,HR,and scores of Ransay and VAS were no statistical significance between the 2 groups.Serum level of IL-6,IL-8,and TNF-α in the observation group was lower,while LVEF and E/A were higher,than the control group after 1 d operation (P ＜ 0.01).Conclusion Effect of sevoflurane anesthesia in endoscopic submucosal dissection for gastric cancer is well,and protect heart function.