腹腔鏡胃癌根治術術中持續循環腹腔內熱灌注化療對靜吸復合麻醉中順式阿曲庫銨用量和作用時間的影響分析

[摘要] 目的 研究探討腹腔鏡胃癌根治術術中持續循環腹腔內熱灌注化療對靜吸復合麻醉中順式阿曲庫銨用量和作用時間的影響。方法 方便選取在該院收治的胃癌患者101例作為研究對象，所有患者均行腹腔鏡胃癌根治術治療，并給予靜吸復合麻醉，將其按照術中是否給予持續循環腹腔內熱灌注化療分為兩組，觀察組和對照組各有51例和50例，分別比較兩組患者麻醉時的順式阿曲庫銨用量、作用時間。結果 分別對兩組患者靜吸復合麻醉過程中順式阿曲庫銨的使用量、作用時間進行比較，可見觀察組患者的使用量顯著升高，而TOFr75和TOFr90與對照組相比顯著縮短，比較差異均有統計學意義（P<0.05）。結論 腹腔鏡胃癌根治術術中給予持續循環腹腔內熱灌注化療能顯著提高順式阿曲庫銨的使用量，且由于代謝速度的加快，且對患者的作用時間明顯縮短。

[關鍵詞] 腹腔鏡胃癌根治術；術中持續循環腹腔內熱灌注化療；靜吸復合麻醉；順式阿曲庫銨

[中圖分類號] R614 [文獻標識碼] A [文章編號] 1674-0742（2016）11（c）-0054-03

[Abstract] Objective To study the effects of laparoscopic radical gastrectomy for gastric cancer surgery a continuous cycle of intraperitoneal hyperthermic perfusion chemotherapy on CIS atracurium dosage and time effects of inhalational combined intravenous anesthesia. Methods Convenient selected in 101 patients with gastric cancer in our hospital as the object of study， all patients underwent laparoscopic gastric cancer radical operation in the treatment of， and to give intravenous inhalation anesthesia， the according to operation whether to give continuous cyclic peritoneal hyperthermic perfusion chemotherapy were divided into two groups， observation group and control group each 50 patients and 51 patients， anesthesia were compared between the two groups of Shun A-type atracurium dosage， action time. Results Of two groups of patients with static ceiling anesthesia process CIS atracurium the use amount and reaction time were compared， visible observation group increased significantly， and TOFr75 and TOFr90 and control group is significantly reduced compared， there were statistically significant differences （P < 0.05）. Conclusion Laparoscopic surgery for gastric cancer radical surgery in given continuous cycle of intraperitoneal hyperthermic perfusion chemotherapy can significantly improve shun the use amount of the type of atracurium and due to speed up the metabolic rate and duration of patients with shortened significantly.

[Key words] Laparoscopic radical gastrectomy for gastric cancer； Lasting operation cycle of intraperitoneal hyperthermic perfusion chemotherapy； Intravenous Inhalation Combined Anesthesia； CIS type atracurium

腹腔熱灌注化療配合腹腔鏡胃癌根治術的應用可以發揮預防治療術后腹膜種植轉移的作用，治療過程中，其可引起患者的體溫升高，并致血流動力學狀態改變、凝血功能降低而腹膜血管通透性提高[1]。同時，體溫升高還會對相關麻醉藥物的代謝造成影響，進而使麻醉深度、時間、用量及代謝情況發生改變。順式阿曲庫銨作為常用的非去極化肌松藥，在臨床麻醉中有廣泛的應用。……