围术期预防性麻醉管理在老年肺癌手术患者中的应用及对血流动力学和预后的影响

Application of perioperative preventive anesthesia management in elderly patients with lung cancer and its effect on hemodynamics and prognosis

目的探讨围术期预防性麻醉管理在老年肺癌手术患者中的应用及对血流动力学和预后的影响。方法将2015年1月至2021年12月该院收治的99例老年肺癌患者分为观察组50例和对照组49例。对照组采用常规麻醉管理,观察组采用围术期预防性麻醉管理,比较两组血流动力学及预后改善情况。结果麻醉诱导前,两组心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)、心排血量(CO)水平及血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平比较,差异均无统计学意义(P>0.05)。拔管35 min后观察组HR、MAP、CVP、CO水平高于对照组,差异均有统计学意义(P<0.05);术后3 d两组血清CRP、TNF-α水平较术前降低,观察组术后3 d血清CRP、TNF-α水平及麻醉并发症总发生率均低于对照组,差异均有统计学意义(P<0.05)。观察组住院时间以及恢复行走时间少于对照组,差异有统计学意义(P<0.05)。结论围术期预防性麻醉管理应用于老年肺癌手术,对患者的血流动力学效果较好,且患者预后改善佳,具有推广价值。

Objective To investigate the effect of perioperative preventive anesthesia management on hemodynamics and prognosis in elderly patients with lung cancer.Methods Ninety-nine elderly patients with lung cancer treated in this hospital from January 2015 to December 2021 were divided into the observation group(50 cases)and control group(49 cases).The control group adopted the routine anesthesia management and the observation group adopted the perioperative preventive anesthesia management.Results Before anesthesia induction,the levels of heart rate(HR),mean arterial pressure(MAP),central venous pressure(CVP)and serum C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)had no statistically significant differences between the two groups(P>0.05).The levels of HR,MAP,CVP and CO at 35 min after extubation in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The postoperative serum CRP and TNF-αlevels in the two groups were decreased compared with those before operation,the serum CRP and TNF-αlevels on postoperative 3 d in the observation group and the total occurrence rate of anesthesia complications were lower those in the control group,and the differences were statistically significant(P<0.05).The hospitalization time and walking recovery time in the observation group were lower than those in the control group with statistical difference(P<0.05).Conclusion Perioperative preventive anesthesia management in elderly patients with lung cancer has better hemodynamic efficacy,moreover the prognosis improvement is good with promotion value.