不同年龄直肠癌根治术患者行丙泊酚麻醉的临床比较

Clinical Comparison of patients with radical resection of rectal carcinoma in different ages treated by propofol anesthesia

目的探讨不同年龄直肠癌根治术患者行丙泊酚麻醉的临床差异。方法选取行直肠癌根治术的69例患者为研究对象,按年龄分为中青年组28例和老年组41例,静脉持续输注丙泊酚20 mg/Kg^(-1)·h^(-1)至患者意识消失时停药,观察、记录并比较两组患者丙泊酚用量、意识消失时麻醉趋势指数(NI)、意识消失时间及用药前后血流动力学指标包括心率(HR)、收缩压(SBP)、舒张压(DBP)及血氧饱和度值(SpO_2)。结果中青年组丙泊酚用量(1.76±0.23)mg/Kg^(-1)显著比老年组高,意识消失时间(317.70±46.30)s显著比老年组长,NI(53.48±10.94)显著低于老年组(P<0.05);中青年组在T_(1-0)、T_(2-1)ΔSBP分别为(13.73±10.88)mmHg和(15.46±9.73)mmHg、ΔDBP分别为(9.01±5.00)mmHg和(9.36±6.22)mmHg、ΔHR分别为(8.63±1.34)次/分和(9.04±2.17)次/分显著比老年组低(P<0.05),中年组T_(1-0)、T_(2-1)ΔSpO_2比老年组略低,但差异无统计学意义(P>0.05)。结论麻醉诱导意识消失时不同年龄患者丙泊酚用量、意识消失时间及意识消失时NI不同,青壮年患者丙泊酚用量、NI均高于老年患者,且血流动力学各指标变化幅度比老年患者小,因此建议临床直肠癌根治术期间对不同年龄患者可进行不同的辅助治疗及护理干预。

Objective To explore clinical difference of patients with radical resection of rectal carcinoma in dif- ferent ages treated by propofol anesthesia. Methods 69 cases of patients with radical resection of rectal carcinoma treated by propofol anesthesia were selected as study subjects, according to the age, 28 cases were divided into young group and 41 cases in the elderly group, the patients were given continuous intravenous infusion of propofol 20 mg·Kg/h-1 till they lost consciousness, propofol dosage, anesthesia trend index at consciousness loss （NI）, sonsciousness loss time, hemodynamic parameters including heart rate （HR）, systolic blood pressure （SBP）, diastolic blood pressure （DBP） and blood oxygen saturation （SpO2） of the two groups of patients were observed, recorded and compared. Results Propofol dosage in the young group （1.76±0.23） mg·Kg-1 was significantly higher than the elderly group, consciousness loss time （317.70±46.30）s was significantly longer than the elderly group, NI （53.48±10.94） was significantly lower than the elderly group （ P 〈 0.05 ） ; T1-0, T2-1△SBP were respectively （13.73±10.88） mmHg and （15.46±9.73） mmHg, A DBP were respectively （9.01±5.00） mmHg and （9.36±6.22） mmHg, A HR were respectively （8.63±1.34）times/min and （9.04±2.17）times/min, which were significantly lower than the elderly group （ P 〈 0.05 ）, T1-0, T2-1 △SpO2 in the young group was lower than the elderly group （ P 〉 0.05 ）. Conclusion Anesthesia induction at consciousness loss, propofol dosage, consciousness loss time, NI at consciousness loss of patients in different ages is different, propofol dosage, NI in the young group were higher than the elderly group, change range of hemodynamic parameters were smaller than the elderly group. Therefore, it is suggested that different adjuvant therapy and nursing intervention for patients with different ages can be carried out during the radical resection of rectal carcinoma.