肿瘤全身热疗期间胃粘膜CO2张力的变化

Changes of Gastrormtramucosal CO2 During Whole Body hyperthermia

目的了解全身热疗（Whole Body Hyperthermia WBH）治疗恶性肿瘤期间，胃粘膜二氧化碳张力（PgCO2）的变化及其临床意义。方法选择26例恶性肿瘤患者在气管插管静吸复合全麻下行全身热疗，治疗温度为41．8℃。用TONOCAPTM胃张力测定仪分别在麻醉前（Ⅰ），麻醉后30rain（Ⅱ），体温达39℃时（Ⅲ）、41．8℃时（Ⅳ），降温至38℃（Ⅴ），及体温正常后1h（Ⅵ）测定PgCO2。同时监测记录MAP、CVP、HR、SPO2，血气分析、血常规及尿量等各项指标。结果静吸复合麻醉下全身热疗期间Pg—CO2随温度升高进行性上升，恒温及降温初期达到最高（P〈0．01），随着降温过程PgCO2随之下降。在体温降至正常后1h，77％患者PgCO2可恢复麻醉前水平。结论全身热疗期间，随着人体温度变化，胃粘膜存在不同程度低灌注，PgCO2能较好的反映这种变化，其敏感性优于MAP、CVP及SPO2的变化。

Objective To investigate Perioperative change of gastrointramucosat CO2 （ PgCO2 ） during Whole Body Hyperthermia（WBH）. Methods 26patients with advanced malignant tumor Scheduled for whole body hyperthermia therapy under general anesthesia were selected. Therapy temperature 41.8℃, PgCO2 was measured at pre-anesthesia（ Ⅰ ） ,30 minutes（ Ⅱ ）after anesthesia,body temperature rise to 39℃ （ Ⅲ）,constant temperature 41.8℃ （Ⅳ） .38℃ （ Ⅴ ）falling phase of temperature,and one hour after normal body temperature （ Ⅵ ）, at the same time, MAP, HR,SPO2, The arterial blood oxygen tension, blood rontine and urine were measured. Results PgCO2 was significantly rising along with temperature at constant and initial falling stage （ P 〈 0. 01 ） , PgCO2 deseented at falling phase of temperature. In 77% patients. PgCO2 recoveried to pre-anesthasia. Conclusion Gastromueosal hypoperfusion related to therapy and anesthesia may occur during whole body hy- perthermia ; PgCO2 may be a more sensitive Variable than MAP ,CVP, SPO2 for gastromucosal perfusion