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宫颈癌子宫切除患者全身麻醉下血流动力学与麻醉意识的关系

Relationship Between Hemodynamics and Anesthesia Consciousness in Patients with Cervical Cancer Undergoing Hysterectomy Under General Anesthesia
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摘要 目的分析宫颈癌子宫切除患者全身麻醉下血流动力学与麻醉意识的关系。方法采用偶遇抽样法,选取2018年8月至2021年12月于商丘市第一人民医院接受腹腔镜下子宫切除术治疗的115例宫颈癌患者为研究对象,患者术中均行全身麻醉,采用麻醉深度多参数监护仪监测患者麻醉诱导前5 min(T_(0))、气管插管前1 min(T_(1))、气管插管时(T_(2))、手术开始时(T_(3))、手术结束时(T_(4))的麻醉意识指数(AI)值,并记录患者T_(0)、T_(1)、T_(2)、T_(3)、T_(4)时血流动力学指标[平均动脉压(MAP)、心率(HR)],分析宫颈癌子宫切除患者全身麻醉下血流动力学与麻醉意识的关系。结果T_(0)、T_(1)、T_(2)、T_(3)、T_(4)时,患者HR、MAP、AI值呈不同程度上下波动,且波动趋势均相同,各时点比较,差异有统计学意义(P<0.05);经广义估计方程固定效应检验,HR、MAP通过对截距项、时点固定效应的P检验,即各时点HR有统计学意义(P<0.05);不同HR、MAP下患者AI值均不同,差异有统计学意义(P=0.044、0.002);经广义估计方程分析,宫颈癌子宫切除患者全身麻醉下各时点HR与AI均具有一定的关系(β=0.155,P=0.002),以T_(0)作为基础观测点,T_(3)时HR值与AI关系最显著(β=-0.278,P=0.007);宫颈癌子宫切除患者全身麻醉下各时点MAP与AI均具有一定的关系(β=-0.102,P=0.044),以T_(0)作为基础观测点,T_(4)时HR值与AI关系最显著(β=0.302,P=0.001)。结论宫颈癌子宫切除患者全身麻醉下血流动力学与麻醉意识具有密切关系。 Objective To analyze the relationship between hemodynamics and anesthesia consciousness in patients with cervical cancer undergoing hysterectomy under general anesthesia.Methods A total of 115 patients with cervical cancer who underwent laparoscopic hysterectomy in Shangqiu First People’s Hospital from August 2018 to December 2021 were selected as the research subjects by convenient sampling method.All patients underwent general anesthesia during the operation.The multi parameter monitor of anesthesia depth was used to monitor the anesthesia awareness index(AI)values of patients 5 min before anesthesia induction(T_(0)),1 min before endotracheal intubation(T_(1)),during endotracheal intubation(T_(2)),at the beginning of operation(T_(3))and at the end of operation(T_(4)),the hemodynamic indexes[mean arterial pressure(MAP)and heart rate(HR)]of patients at T_(0),T_(1),T_(2),T_(3)and T_(4)were recorded,and the relationship between hemodynamics and anesthesia consciousness in patients with cervical cancer undergoing hysterectomy under general anesthesia.Results At T_(0),T_(1),T_(2),T_(3)and T_(4),the values of HR,MAP and AI fluctuated in varying degrees,and the fluctuation trends were the same.There were statistical significant differences at each time point(P<0.05).Through the fixed effect test of generalized estimation equation,HR and MAP passed the P test of the fixed effect of intercept term and time point.In other words,HR at each time point was statistically different(P<0.05).The AI values of patients with different HR and MAP were all different,the difference was statistically significant(P=0.044,0.002).According to the analysis of generalized estimation equation,there was a certain relationship between HR and AI at each time point under general anesthesia in patients with cervical cancer after hysterectomy(β=0.155,P=0.002),T_(0)was taken as the basic observation point,the relationship between HR value and AI was the most significant at T_(3)(β=-0.278,P=0.007).There was a certain relationship between MAP and AI at each time point under general anesthesia in patients with cervical cancer after hysterectomy(β^=-0.102,P=0.044),taking T_(0)as the basic observation point,the relationship between HR value and AI was the most significant at T_(4)(β=0.302,P=0.001).Conclusion There is a close relationship between hemodynamics and anesthesia consciousness in patients with cervical cancer undergoing hysterectomy under general anesthesia.
作者 刘京广 LIU Jingguang(Department of Anesthesiology,Shangqiu First People’s Hospital,Shangqiu 476100,China)
出处 《河南医学研究》 CAS 2022年第18期3342-3346,共5页 Henan Medical Research
关键词 宫颈癌 子宫切除术 全身麻醉 血流动力学 麻醉意识 相关性 cervical cancer hysterectomy general anesthesia hemodynamics anesthesia consciousness correlation
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