|本期目录/Table of Contents|

[1]黄乐林,沈艳喜,李 伟,等.肿瘤全身高温疗法的20例临床麻醉管理[J].医学研究与战创伤救治(原医学研究生学报),2009,11(01):33-36.
　HUANG Le-lin,SHEN Yan-xi,LI Wei,et al.Anesthesia manipulation for 20 cancer patients with whole body hyperthermia[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2009,11(01):33-36.
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肿瘤全身高温疗法的20例临床麻醉管理()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第11卷
期数:
2009年01期
页码:
33-36
栏目:
出版日期:
2009-01-20

文章信息/Info

Title:
Anesthesia manipulation for 20 cancer patients with whole body hyperthermia
文章编号:
1672-271X(2009)01-0033-04
作者:
黄乐林1; 沈艳喜1; 李 伟1; 董桃花2
1.南京军区庐山疗养院麻醉科，江西九江 332000；2.九江市第三人民医院麻醉科，江西九江 332000
Author(s):
HUANG Le-lin1; SHEN Yan-xi1; LI Wei1; DONG Tao-hua2
1.Department of Anesthesia,Lushan Sanatorium of Nanjing Military Command,Jiujiang 33200,Jiangxi，China;2.Department of Anesthesia,the 3rd Peoeles Hospital, Jiujiang 33200，Jiangxi，China
关键词:
高温疗法; 肿瘤; 麻醉
Keywords:
Hyperthermia;  Cancer;  Anesthesia
分类号:
R73-33
DOI:
-
文献标志码:
A
摘要:
目的 探讨全身高温疗法(whole body hyperthennia,WBH)的麻醉管理特点，提高WBH麻醉管理水平。方法 20例晚期癌症患者，采用全身热疗系统加温，静吸复合全麻，监测心率(HR)、脉搏血氧饱和度(SpO2)、心电图(ECG)、呼气末二氧化碳分压值(PetCO2)、平均肺动脉压(PAP)、中心静脉压(CVP)、平均动脉压(MAP)、肺动脉平均压(MPAP),肺毛细血管锲压(PCWP)、心排血量(CO)、心脏指数(Cl)、肺循环阻力(PVR)，外周血管阻力(SVR)、动脉氧饱和度(SaO2)、血糖和肾功能。结果 随着体温的升高，血流动力学和氧代谢参数出现明显的变化。HR、CO、CI、CVP、MPAP、PCWP均升高，恒温期间最明显，而此期MAP、PVR、SVR反而下降(P<0.01);在高温状态下，心脏功能受抑制，发生肺水肿的几率增大，氧耗与氧供均升高。与一般全麻比较，药物分解代谢增快，所需麻药量增多。结论 充分的麻醉前准备，合理的麻醉用药，完善的监控手段，适当的血管活性药物的应用，充分的氧供，酸碱平衡，血气电解质稳定，高血糖，以及各器官功能的维护和合理补液，均有助于提高WBH麻醉的安全性。
Abstract:
Objective To investigate the characteristics of anesthesia manipulation for whole body hyperthermia (WBH) and to enhance the levels of anesthesia manipulation. Methods 20 terminal cancer patients were heated with a whole body heated system and anesthetized with both intravenous and inhaled pathways. Heart rates (HR), pulses, saturation of biood oxygen, electrocardiogram (ECG), concentration of carbon dioxide at end expiration, mean pulmonary arterial pressure (PAP), central venous pressure (CVP), mean arterial blood pressure(MAP), pulmonary capillary pressure (PCP), cardiac output (CO), cardiac index, peripheral vascular resistance(PVR), pulmonary arterial vascular resistance, arterial O2 saturation, glucose and Renal functions were monitored. Results Hemadynamics and oxygen metabolism parameters varied evidently with temperature increasing. HR，COCL，CVP，and PCWP increased even during constant temperatures，while MAP，PVRI and SVRI were decreased (P<0.01). In the hyperthermia，heat functions were inhibited with a tendency to pulmonary edema，and consumption and supply of oxygen increased. Drug metabolism was fast comparing to general anesthesia and anesthesia dosage increased.Conclusion Detailed preparations before anesthesia，suitable application of anesthesia drugs，perfect monitoring methods，appropriate vasoactive drugs，enough oxygen supplies，acid-base balance，stable blood gases & electrolytes，treatment of hyperglycemia，protection for organ functions and reasonable infusion could enhance the anesthesia safety for the whole body hyperthermia.

参考文献/References:

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备注/Memo

备注/Memo:
-
更新日期/Last Update: 2013-11-20