低温麻醉复合控制性降压在骶骨肿瘤切除术中的应用

Research controlled hypotension combined with hypothermia anesthesia's effect on sacral tumor resection

目的 探讨低温麻醉与控制性降压联合对骶骨肿瘤术的影响.方法 回顾分析2010年7月～2012年12月采用低温麻醉与控制性降压联合治疗的骶骨肿瘤术患者75例的临床资料（观察组）;并与同期采用预先前路双侧或单侧结扎髂内动脉和骶正中动脉的75例患者（对照组）进行比较,比较两组患者的手术时间、术中出血量、血流动力学和5年生存率等.结果 观察组手术时间和出血量均显著低于对照组（P＜0.05）;观察组术后血流动力学均较正常,但对照组SBP显著升高（P＜0.05）,而SPO2显著下降（P＜0.05）;观察组5年生存率高于对照组,但两组无显著差异.结论 对于骶骨肿瘤切除术,低温下控制性降压有效控制出血,不影响患者血流动力学,减少并发症,提高5年生存率,值得临床推广.

Objective To investigate the hypothermia anesthesia and controlled hypotension effect on sacral tumor re- section. Methods Retrospectively analyzed the clinical data of 75 sacral tumor resection patients with hypothermic anesthesia and controlled hypotension from July 2010 to December 2012 as observation group,compared with the same period 75 cases with internal iliac artery and the middle sacral artery, used the treatment of anterior by advance bilat- eral or unilateral ligation as the control group, compared the two groups of operation time,intraoperative bleeding vol- ume, hemodynamics and survival rate in 5 years. Results The observation group＇s operation time and bleeding volume were significantly lower than those in the control group （P 〈 0.05）;The patients in the observation group＇s blood flow dynamics were normal ,but the control group of SBP were significantly increased （P〈0.05）,while SPO2 decreased sig- nificantly （P 〈 0.05 ） 5 years survival rate in observation group was higher than the control group ,but had no signifi- cant difference between the two groups. Conclusion For sacral tumor resection,controlled hypotension and effective control of hemorrhage under low temperature,does not affect the hemodynamics in patients,reduce the complications, improve the survival rate in 5 years, is worth the clinical promotion.