胃癌根治术中腹腔热化疗对血流动力学的影响

Effects of hyperthermic peritoneal chemiotherapy on hemodynamics during the gastric cancer radical resection

目的 :观察胃癌根治手术中进行腹腔热化疗对血流动力学的影响。方法 :择期年龄 31- 75岁胃癌根治手术病人 2 6例 ,在手术切除癌肿准备关腹前行低渗腹腔热化疗。记录热化疗前和热化疗过程中血流动力学指标并分析。结果 :心率 (HR)显著增快 ,至化疗结束后又显著减慢。过程中平均动脉压 (MAP)显著下降 ,结束后恢复到热灌洗前水平。总外周阻力指数 (SVRI)由 (1830± 36 2 )降至 (1340± 2 70 )dyn·s·cm-5·m-2 ,平均肺动脉压 (MPAP)、肺动脉楔压 (PAWP)均较热化疗前显著增高 ,化疗结束即恢复正常。结论

AIM: To evaluate the effects of hyperthermic peritoneal chemiotherapy (HPC) on cardiovascular system. METHODS: Twenty-six patients whose age was 31 to 75 receiving gastric cancer radical resection followed by HPC were involved in this trial. All hemodynamic parameters were recorded during whole procedures. RESULTS: The blood temperature(T) increased significantly during HPC; cardiac index increased immediately when HPC began( P< 0 01) and was maintained at a high level. Heart rate increased during HPC in the first ten min [(96.1±16.2) beats/min ( P< 0.01 vs before HPC)] and return to normal when HPC stopped. During HPC,mean artery pressure and SVRI decreased ( P< 0.01). Meanwhile,MPAP, PAWP also changed significantly, which returned to normal when HPC ended. CONCLUSION: The hemodynamics during HPC requires careful anesthetic monitoring and management to ensure the patients safety.