复方右旋糖酐40注射液预扩容对老年结直肠癌患者血流动力学的影响

Effect of pre-expansion by Compound Dextran 40 injection before anesthesia induction on hemodynamics of older patients with colorectal cancer

目的研究复方右旋糖酐40注射液用于麻醉诱导前预扩容对老年结直肠癌患者生命体征和血流动力学的影响。方法纳入本院2013年10月至2016年10月70例老年结直肠癌患者作为研究对象,随机分为两组,每组各35例。麻醉诱导前观察组予复方右旋糖酐40注射液预扩容,对照组给予聚明胶肽预扩容。比较两组手术期间生命体征和血流动力学指标变化情况,记录两组血管活性药物使用、不良反应发生及术后复苏情况。结果观察组患者心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心输出量(CO)及每搏输出量(SV)在麻醉前30 min(T_1)、气管插管前即刻(T_2)、麻醉诱导后10 min时(T_3)及手术结束时(T_4)各时间点均无显著性变化(均P>0.05),对照组各指标水平在各时间点波动显著(P<0.05)。观察组使用血管活性药物病例数显著少于对照组(P<0.05)。两组苏醒时间、拔管时间及不良反应发生率无显著性差异(P>0.05)。结论复方右旋糖酐40注射液用于老年结直肠癌患者麻醉诱导前预扩容有助于术中生命体征和血流动力学的稳定,减少低血压和血管活性药物使用量,且不影响麻醉效果。

Objective To investigate the effect of Compound Dextran 40 Injection on the vital signs and hemodynamics of older patients with colorectal cancer before anesthesia induction. Methods 70 elderly patients with colorectal cancer in our hospital from October 2013 to October 2016 were randomly assigned into two groups, with 35 cases in each group. The treatment group was treated with pre-expansion by compound dextran 40 before anesthesia induction, and the control group by poly gelatin peptide. The changes of vital signs and hemodynamic indices were compared. The use of vasoactive drugs, adverse reactions and postoperative recovery of the two groups were recorded. Results The heart rate（HR）, systolic blood pressure（SBP）, diastolic blood pressure（DBP）, mean arterial pressure（MAP）, cardiac output（CO） and stroke volume（SV） in the treatment group in 30 min before anesthesia（T1）, immediately before intubation（T2） after induction of anesthesia, 10 min（T3） and at the end of surgery（T4） did not change significantly（P〉0.05）. The level of each index fluctuated significantly at each time point in the control group（P〈0.05）. Use of vasoactive drugs in the treatment group were significantly less than those in the control group（P〈0.05）. There was no significant difference in the recovery time, extubation time and adverse reactions between the two groups（P〉0.05）. Conclusion Compound Dextran 40 Injection is helpful in preanesthesia expansion of older patients with colorectal cancer to improve the stability of vital signs and hemodynamics during operation.It can reduce blood pressure and use of vasoactive drugs, while does not affect the anesthetic effect.