合并心血管疾病的高龄结直肠癌病人腹腔镜手术的麻醉处理

Anesthesia management in aged colorectal carcinoma patients with cardiovascular disease undergoing laparoscope surgical operation

目的:探讨合并心血管疾病的高龄结、直肠癌病人行腹腔镜手术的麻醉安全性。方法:对29例合并心血管疾病的高龄结、直肠癌病人行腹腔镜手术的麻醉管理资料进行回顾性分析。结果:全组病例手术时间平均182 min,气腹时间平均136 min,人工气腹对多项呼吸、循环功能有一过性显著影响(P<0.05-<0.01),30 min后则与气腹前无显著差异。气腹致单肺通气和皮下气肿各1例,3例转开腹手术,无麻醉死亡病例。结论:因充分的术前准备,加强术中、后监测,妥善处理并发症,合并心血管疾病的高龄病人腹腔镜下行结、直肠癌手术的麻醉是安全的。

Objective： To study the security of anesthesia in aged colorectal carcinoma patients with cardiovascular disease （CVD） undergoing laparoscope surgical operation （LSO）. Methods： To carry out a retrospective analysis to anesthesia management in 29 aged colorectal carcinoma patients with CVD undergoing LSO. Results： The average surgical operation time was 182 min and the average aeroperitoneum time was 136 min in 29 subjects. Both of the respiration and circulation function were influenced by artificial aeroperitoneum （P〈0. 05-〈0. 01） in 10 min, but there were no significant difference between before and 30 min after aeroperitoneum. One case with one-lung ventilation and one with subcutaneous emphysema caused by aeroperitoneum were observed in this study. No death case was observed. Conclusion ： With sufficient preparations before operation, enhanced monitors during and after operation and appropriate management of the complications, anesthesia in aged colorectal carcinoma patients with cardiovascular disease undergoing laparoscope surgical operation is safe.