肿瘤全身热疗的麻醉管理体会

Study on anesthesia management of the patients with various malignancies undergoing whole body hyperthermia

目的探讨晚期恶性肿瘤患者全身热疗的麻醉管理。方法 22例次肿瘤患者,采用ET-SPACETM红外线全身热疗系统加温,静吸复合全麻。术中监测IBP、CVP、SPO2、HR、ECG及血气分析。结果随着体温的升高,血流动力学等参数出现明显的变化,HR、CVP均升高,恒温期间最明显,MAP反而下降,PH、BE、HCO3-1值随着体温升高而下降,一直持续到降温期。结论术前充分准备、合理的麻醉用药、完善的监测、合理的补液,维持循环稳定,有助于提高全身热疗的安全性。

Objective To explore the management of anesthesia of whole body hyperthermia in terminal malignant tumor patients.Methods 22 cases patients who suffered malignant tumor were investigated,after general anesthesia of intravenous absorption,whole body hyperthermia was performed with ET-SPACETM far infrared radiation space.Invasive blood pressure（IBP）,central venous pressure（CVP）,SPO2,HR,electrocardiograph（ECG）,arterial blood gas were monitored.Results With the increase of body temperature,HR and CVP increased,while MAP,PH,BE,HCO3^-1 decreased progressively.These changes reached the peak levels at the late period of hyperthermia phase.There parameters gradually recovered to pre-operative level as temperature decreased.Conclusion The preoperative preparation rational drug use of anesthesia,improving the monitoring,and a reasonable fiuid to maintain circulation stability help to improve the security of whole body hyperthermia.