老年人结直肠癌腹腔镜手术的麻醉处理

Anesthetic Management in Laparoscopic Surgery of Colorectal Cancer in Elderly Patients

目的探讨老年人腹腔镜下结、直肠癌手术麻醉的安全性。方法回顾性分析85例>70岁行腹腔手术的结、直肠癌病人的麻醉资料。结果气腹后心率(HR)、平均动脉压(MAP)、呼吸末CO2分压(PETCO2)、气道峰压(Ppeak)较气腹前显著升高,经处理,其中80例患者术中上述各值在正常范围,2例出现高碳酸血症,3例皮下气肿并PETCO2异常升高,经过度通气等治疗后,均恢复良好,无麻醉死亡病例。结论充分术前准备,加强术中监测管理,妥善处理并发症,老年人腹腔镜下行结、直肠癌手术的麻醉是安全的。

Objective To evaluate the safety of anesthesia in laparoscopic surgery in elderly patients with colorectal cancer. Methods Retrospective study the anesthetic data of 85 cases of laparoscopie surgery of colorectal cancer, all the patients of these cases were over 70 years old. Results After arti- ficial pneumoperitoneum , HR,MAP.PET CO2 ,Ppeak increased obviously. Through appropriately treat,80 cases were kept in normal range only, 2 occurred hypercapnia, 3 cases subcutaneous emphysema and PET CO2 increased abnormally. All these complications recovered well by hyperventilation, and no one died of anesthesia. Conclusion With careful preoperative preparation, strengthening intraoperative monitoring, and appropriately handling complications, it is safe to old men of accepting anesthesia in laparoscopic surgery of colorectal cancer.