全凭静脉麻醉与静脉-吸入复合麻醉在胃癌手术中的应用效果比较

Comparison of Application Efficacy of Total Intravenous Anesthesia And Intravenous Inhalation Combined Anesthesia in Gastric Cancer Surgery

目的:比较全凭静脉麻醉与静脉-吸入复合麻醉在胃癌手术中的应用效果.方法:选择2018年12月至2019年12月于台前县人民医院行胃癌根治术的107例患者为研究对象.采用随机数表法分为观察组(n=53)及对照组(n=54).观察组行全凭静脉麻醉,对照组行静脉-吸入复合麻醉.比较两组两组麻醉前(T0)、手术开始15min(T1)、手术开始45min(T2)及术闭30min(T3)平均动脉压(MAP)、心率、动脉血二氧化碳分压(PCO_(2))、动脉血氧分压(PO_(2))及术后认知功能障碍(POCD)发生情况.结果:T1、T2及T3两组PCO_(2)水平先上升后下降,心率、MAP、PO2水平先下降后上升,且观察组改变幅度小于对照组,两组组间、时间点、时间点与组间交互比较,差异有统计学意义(P<0.05);观察组术后POCD发生率低于对照组(P<0.05).结论:胃癌手术患者行全凭静脉麻醉对血流动力学影响小,可有效改善患者血气分析指标,降低术后POCD发生率.

Objective:To compare the effect of total intravenous anesthesia and intravenous inhalation combined anesthesia in gastric cancer surgery.Methods:One hundred and seven patients who underwent radical gastric cancer surgery in Taiqian County People's Hospital from December 2018 to December 2019 were selected as study subjects and were randomly divided into the observation group(n=53)and the control group(n=54).The observation group received total intravenous anesthesia,and the control group received intravenous inhalation combined anesthesia.The mean arterial pressure(MAP),heart rate,arterial partial pressure of carbon dioxide(PCO_(2)),arterial partial pressure of oxygen(PO_(2),)and postoperative cognitive impairment(POCD)were compared between the two groups before anesthesia(TO),15 minutes from the beginning of the operation(T1),45 minutes from the beginning of the operation(T2)and 30 minutes from the closure(T3).Results:At T1,T2,and T3,the PCO_(2),levels of the two groups were first increased and then decreased,while the heart rate,MAP and PO,levels were first decreased and then increased.And the increase and decrease of the observation group were smaller than those of the control group.between the two groups,The time point,the time point and the interaction were compared between the two groups,and the statistically significant difference were found(P<0.05).The incidence of POCD in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Total intravenous anesthesia for patients with gastric cancer surgery has little effect on the incidence of hemodynamics,which can effectively improve the blood gas analysis indexes of patients with gastric cancer surgery and reduce the incidence of postoperative POCD.