七氟醚吸入麻醉与丙泊酚静脉麻醉在超声引导下经皮微波消融治疗肝癌中的应用

Application of general anesthesia with sevoflurane or intravenous propofol in percutaneous sonographically guided microwave coagulation therapy for hepatocellular carcinoma

目的比较七氟醚吸入麻醉和丙泊酚静脉麻醉在超声引导下经皮微波消融疗法(PMCT)治疗肝癌中应用的优缺点。方法选取40例原发肝癌患者,随机均分为七氟醚吸入麻醉组(S组)和丙泊酚静脉麻醉组(P组)。观察两组的诱导时间、苏醒时间、术中BP、HR和SpO2的变化,以及术中和术后并发症的发生情况。结果两组诱导时间和苏醒时间之间的差异无统计学意义。P组治疗前后SBP、DBP和SpO2波动大于S组(P<0.05);S组恶心、呕吐的发生率较高,而P组注射痛和呼吸暂停的发生率高(P<0.05)。结论两种麻醉方法均能满足PMCT治疗肝癌的要求,七氟醚麻醉对呼吸、循环影响更小,但恶心、呕吐的发生率较高。

Objective To compare the advantages and disadvantages of inhalation anesthesia with sevoflurane and intravenous anesthesia with propofol in percutaneous sonographically guided microwave coagulation therapy（PMCT） for hepatocellular carcinoma （HCC）. Methods Forty HCC patients were allocated randomly to two groups with 20 cases each. The patients in group S received inhalation anesthesia with sevoflurane and those in group P intravenous anesthesia with propofol during PMCT for HCC. The induction time, recovery time, BP, HR, SpO2 and complications were assessed. Results There were no statistically signifcant difference between the two groups in induction time and recovery time. The changes of SBP,DBP and SpO2 were more in group P than those in group S（P〈0.05）. The incidence of PONV was higher, in group S than that in group P,but that of injection pain and apnoea was higher in group P than that in group S（P〈0.05）. Conclusion Both sevoflurane and propofol can provide satisfactory anesthesia for the operation of HCC with PMCT. Anesthesia with sevoflurane has less effect on the respiratory and circulatory function than that with propofol,but more PONV.