山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (4): 62-64.doi: 10.6040/j.issn.1673-3770.0.2015.034

• 论著 • 上一篇    下一篇

静脉全麻对鼻内镜手术中出血量的影响

王宏梗1, 陈东生2, 林群3, 黄方4, 洪育明4, 黄建强4   

  1. 1. 福建医科大学附属第二医院麻醉科, 福建 泉州 362000;
    2. 南京军区福州总医院麻醉科, 福建 福州 350000;
    3. 福建医科大学附属第一医院麻醉科, 福建 福州 350005;
    4. 福建医科大学附属第二医院耳鼻咽喉科, 福建 泉州 362000
  • 收稿日期:2015-01-13 修回日期:2015-06-11 出版日期:2015-08-16 发布日期:2015-08-16
  • 通讯作者: 黄方。E-mail:hf-ent@163.com E-mail:hf-ent@163.com
  • 作者简介:王宏梗。E-mail:whg98@sina.com
  • 基金资助:
    泉州市科技计划项目(2008Z22)

Effects of total intravenous anesthesia on the bleed volume during endoscopic sinus surgery.

WANG Honggeng1, CHEN Dongsheng2, LIN Qun3, HUANG Fang4, HONG Yuming4, HUANG Jianqiang4   

  1. 1. Department of Anesthesiology, The Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian, China;
    2. Department of Anesthesiology, Fuzhou General Hospital of Nanjing Millitary Command, Fuzhou 350000, Fujian, China;
    3. Department of Anesthesiology, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian, China;
    4. Department of Otolaryngology, The Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian, China
  • Received:2015-01-13 Revised:2015-06-11 Online:2015-08-16 Published:2015-08-16

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摘要： 目的 观察综合措施基础上静脉全身麻醉对鼻内镜手术中出血量的影响。方法 将60例患者随机分为2组, 每组30例。A组为静脉全麻组, B组为吸入全麻组。两组患者诱导气管插管后, A组以丙泊酚及瑞芬太尼持续泵注维持麻醉至手术结束前5 min停药;B组以吸入七氟烷维持麻醉, 手术结束前5 min停药。两组均行桡动脉置管测压和采血, 综合措施包括:手术开始前15 min行急性高容量血液稀释、控制性降压及静脉注射蛇毒类血凝酶1.0单位。观察手术开始前30 min(T0)、手术开始后30 min(T1)、90 min(T2)及手术结束后30 min(T3)4个时间点的动脉血气、静脉血乳酸浓度、凝血功能变化。记录2组患者手术结束时术中出血量及手术时间。结果 与T0比较, T1、T2、T3 3个时间点动脉血气、静脉血乳酸浓度及凝血功能差异无统计学意义(P>0.05)。A组手术出血量明显少于B组(P<0.05)。结论 综合措施基础上采用静脉全身麻醉有助于减少鼻内镜手术中出血量。

关键词: 控制性低血压, 鼻内镜外科手术, 出血量, 静脉麻醉

Abstract: Objective To explore the effect of total intravenous anesthesia on the bleed volume during endoscopic sinus surgery. Methods A total of sixty adult patients(ASAⅠ-Ⅱ), agreed to be on electively endoscopic sinus surgery, were randomly divided into two groups(group A and group B, n=30 each). All patients were injected intravenously with fentanyl, propofol and cisatracurium during the induction of general anesthesia. During the maintaince stage of the general anesthesia, patients in group A were injected intravenously with propofol and patients in group B were inhalated with sevoflurane until 5 minutes before the end of the operation. All patients were monitored with arterial blood pressure, were hepervolumic diluted and were performed with controlled hypotention 15 minutes before the operation. The arterial blood gas, blood lactate and coagulation function were monitored 30 minutes before the operation(T0), 30 minutes(T1) and 90 minutes after the operation (T2) and 30 minutes after the end of the operation(T3). Bleed volume and operation duration were recorded at the end of the operation. Results Comparing with those at T0, there was no significant difference in the arterial blood pressure, blood lactate and coagulation function at T1, T2 and T3. Bleed volume in group A was few than that in group B(P<0.05). There was no significant difference in the operation duration between the two groups. Conclusion During the endoscopic sinus surgery with intravenous anesthesia, the bleed volume is few than that with inhalation anesthesia.

Key words: Bleed volume, Endoscopic sinus surgical procedures, operative, Intravenous anesthesia, Controlled hypertension

中图分类号: 

  • R765.9
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