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目的探讨七氟烷吸入麻醉对不同年龄层消化道肿瘤患者血液流变学的影响。方法选取2010年3月至2013年3月间收治的120例消化道肿瘤患者作为研究对象,按照年龄分为2组,即年龄<60岁(A组)和年龄≥60岁(B组),每组各60例。所有患者均采用根治手术治疗,进行麻醉诱导后,以七氟烷、瑞芬太尼、罗库溴铵进行麻醉维持,分析患者的血液流动变化学以及红细胞变化情况。结果施行麻醉后,A组患者T1(最低肺泡气有效浓度保持在1~1.3并持续1 h)的高切变速度(Hηb)、中切变速度(Mηb)、低切变速度(Lηb)、血浆黏度(ηb)及全血还原黏度(ηr)较T0(麻醉开始前)均显著减小,差异均有统计学意义(均P<0.05)。B组患者T1的Hηb、Mηb、Lηb、ηb及ηr较T0均显著减小,差异均有统计学意义(均P<0.05)。且B组患者Hηb减小程度较A组明显,差异有统计学意义(P<0.05)。两组患者T1的红细胞聚集指数(EAI)较T0均减少,差异均有统计学意义(均P<0.05)。B组患者T1的红细胞变形指数(EDI)较T0显著下降,差异有统计学有意义(P<0.05);A组患者T1的EDI较T0变化不明显,差异无统计学意义(P>0.05)。B组患者T1的红细胞刚性指数(ERI)较T0减小,差异有统计学意义(P<0.05)。结论七氟烷吸入麻醉药能明显降低消化道肿瘤患者的血液流变学观察值,减少血液黏度,降低血栓发生的可能性,提高手术安全性。
Objective To investigate the effects of sevoflurane inhalation anesthesia on hemorheology in patients with digestive tract tumors of different ages. Methods A total of 120 patients with gastrointestinal cancer who were treated between March 2010 and March 2013 were selected and divided into two groups according to their age: group A (age <60) and group A (group B> age 60) 60 cases in each group. All patients were treated by radical surgery. After induction of anesthesia, anesthesia was maintained with sevoflurane, remifentanil and rocuronium. The blood flow variability and erythrocyte changes were analyzed. Results After being anesthetized, the high shear rate (Hηb), mid-shear rate (Mηb) and low shear rate (Lηb) of T1 group (the lowest effective concentration of alveolar gas maintained at 1 ~ 1.3 for 1 h) Plasma viscosity (ηb) and whole blood reduction viscosity (ηr) were significantly lower than T0 (before anesthesia), the differences were statistically significant (P <0.05). The values of Hηb, Mηb, Lηb, ηb and ηr in T1 group were significantly lower than those in T0 group (all P <0.05). The reduction of Hηb in group B was more significant than that in group A (P <0.05). The erythrocyte aggregation index (EAI) of T1 in both groups was lower than that in T0, the differences were statistically significant (all P <0.05). The EDI of T1 in group B was significantly lower than that in T0 (P <0.05). The EDI of T1 in group A was not significantly different from T0 (P> 0.05) . The erythrocyte rigidity index (ERI) of T1 in group B was lower than that in T0, the difference was statistically significant (P <0.05). Conclusion Sevoflurane inhalation anesthetics can significantly reduce hemorheology in patients with gastrointestinal cancer, reduce blood viscosity, reduce the possibility of thrombosis and improve the safety of surgery.