|本期目录/Table of Contents|

[1]卢 杰,王玉秀,张应祥,等.全身热疗对肿瘤患者肺换气功能的影响[J].医学研究与战创伤救治(原医学研究生学报),2011,13(02):130-132.
　LU Jie,WANG Yu-xiu,ZHANG Ying-xiang,et al.Effect of whole body hyperthermia on pulmonary gas exchange in patients with malignant tumors[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2011,13(02):130-132.
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全身热疗对肿瘤患者肺换气功能的影响()
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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13卷
期数:
2011年02期
页码:
130-132
栏目:
出版日期:
2011-03-20

文章信息/Info

Title:
Effect of whole body hyperthermia on pulmonary gas exchange in patients with malignant tumors
文章编号:
1672-271X(2011)02-0130-03
作者:
卢 杰; 王玉秀; 张应祥; 宗 林
223001 江苏淮安，解放军82医院麻醉科
Author(s):
LU Jie;  WANG Yu-xiu;  ZHANG Ying-xiang;  ZONG Lin
Department of Anesthesiology, 82 Hospital of PLA, Huaian, Jiangsu 223001, China
关键词:
麻醉; 肿瘤; 高温; 诱发; 肺功能
Keywords:
anesthesia;  neoplasm; hyperthermia;  induced; pulmonary function test
分类号:
R730.56
DOI:
-
文献标志码:
A
摘要:
目的 探讨全身麻醉下全身热疗对肿瘤患者肺换气功能的影响。方法 晚期肿瘤20例，ASA I~Ⅱ级，排除影响肺功能的基础疾病、老年、肥胖等因素。在静脉复合麻醉下，用国产ET-SpeacTM仓加温，体温达到41.8℃后维持1 h开仓降温，体温降到38.5℃时行麻醉复苏。在维持机体良好的纯氧肺通气、有效的血流灌注、正常的水电解质和酸碱平衡等前提下，观察加温前、升温期(39℃、40℃、41℃、41.8℃)、41.8℃持续1 h、降温期(40℃、38.5℃)、38.5℃后1 h各时点的肺泡-动脉氧分压差(PA-aO2 )、动脉-肺泡氧分压比率(a/AO2 )、呼吸指数(RI)、氧合指数(OI)、肺内分流率(Qs/Qt)等参数的变化。结果 升温期RI、a/AO2在39℃时即出现显著变化(P<0.05)，40℃时PA-aO2、OI、Qs/Qt也发生显著改变(P<0.05)。恒温结束时上述变化均达到最大值(P<0.01)，其中PA-aO2、RI、Qs/Qt较加温前增加1~2倍，a/AO2 、OI下降35%左右。降温期各指标的变化值有所减少，但与加温前比较仍有显著变化(P<0.01)。结论 全身麻醉下全身热疗对肿瘤患者肺换气功能有明显的损害，应予以足够重视。
Abstract:
Objective To explore the effect of whole body hyperthermia (WBH) on pulmonary gas exchange function under general anesthesia in patients with malignant tumors. Methods 20 patients with advanced malignant tumors, ASA I to II, and without basic diseases, advanced age and obesity that might affect lung function, were treated with WBH. The patients were placed in the treatment chamber of ET-SPACETM under complex intravenous anesthesia, and heat was generated to 41.8℃ and maintained at this temperature for 1 hour, then allowed to cool. Anesthesia resuscitation was performed when the body temperature reduced to 38.5℃. PA-aO2, a/AO2, RI, OI and Qs/Qt were monitored at different time points: before heating, heating to 39℃, 40℃, 41℃, 41.8℃, 1 hour after maintenance at 41.8℃, cooling to 40℃, 38.5℃, and 1 hour after 38.5℃. Results During heating period, significant changes of RI and a/AO2 were observed at 39℃, and also of PA-aO2, OI and Qs/Qt at 40℃ (P<0.05). One hour after maintenance at 41.8℃, maximum changes of the above parameters were observed: PA-aO2, OI and Qs/Qt increased by 1-2 times, and RI and a/AO2 decreased by 35% as compared with those before heating. During cooling period, the changes of the above parameters gradually decreased, but were still significant compared with those before heating (P<0.01). Conclusion Under general anesthesia, WBH may impair pulmonary gas exchange in patients with malignant tumors, which merits high attention.

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备注/Memo

备注/Memo:
-
更新日期/Last Update: 2011-03-20