靶控输注异丙酚在WBH-CT中的应用研究

Assessment of propofol TCI duringin whole body hyperthermia patients heated by means of infrared radiation.

目的探讨靶控输注异丙酚在全身热疗联合化疗（WBH-CT）中应用的可行性及安全性。方法32例晚期肿瘤患者在靶控输注异丙酚静脉麻醉下进行WBH—CT。观察热疗前（T0），加温到39℃（T1）、41．5℃（T2）、维持41．5℃120min（T3）、复温到39℃（T4）时点血液动力学、呼吸频率、血浆肌钙蛋白I（cTnI）、乳酸、肝肾功能、动脉血气、电解质变化。结果与T0比较，T1～T4时点平均桡动脉压（MAP）下降、HR及RR增快．T2～T3时点中心静脉压（CVP）降低，T3～T4时点血浆乳酸浓度增加．P均〈0．05；与T0比较，T1～T4时点TBIL、TP、ALB血清浓度降低，P均〈0．05；患者无明显不良反应。结论晚期肿瘤患者靶控输注异丙酚行WBH-CT是一种安全、方便、可行的麻醉方法。

[Objective] In order to assess the safety and feasibility of propofol TCI during whole body hyperthermia combined with chemotherapy.[Method] 32 tumor patients were scheduled for whole body hyperthermia by using radiation systems with infrared radiation with anesthesia of propofol TCI. And the data of hemodynamics, respiratory rate, cTnI ,latctae, liver and renal function, arterial blood gas and electrolyte changes were obtained before whole body hyperthermia（T0） , at 39℃ （T1）, 41.5℃ （T2）, 120 min after constant 41.5℃ （T3）and re-warming to 39℃（T4）. [Results] Compared with To, there were none significantly change of pH, PaO2, PaCO2, HCO3, T-CO2, plasma ALT, AST, Cr, BUN, cTnI, K^＋, Na^＋ and Ca^2＋. But MAP significantly deceased, while HR, RR, plasma TP and ALB increased at T1-T4; CVP decreased at T2-T3;lactate increased at T3-T4. The serum concentration of TBIL,TP and ALB decreased at T1-T4,P〈0.05. There were no side effect after whole body hyperthermia. [Conclusion] Intravenous anesthesia with propofol TCI during whole body hyperthermia malignant tumor patients is safe, convenient and feasible.