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目的:探讨晚期恶性肿瘤患者行全身热疗联合化疗的麻醉管理特点。方法:18例恶性肿瘤患者,在静吸复合全麻下采用红外线辐射体表加热实施全身热疗20次。有创监测血液动力学,肺氧合指标,测定电解质、血糖和尿量。结果:升温期和恒温期心率、中心静脉压升高;平均动脉压、动脉血二氧化碳分压、动脉血pH、BE、血钾和血糖下降,降温期恢复。结论:静吸复合全麻,有创监测血液动力学,纠正内环境失衡,维持心肺功能稳定是全身热疗麻醉处理的关键。
Objective: To investigate the characteristics of anesthesia management in patients with advanced malignant tumors undergoing combined hyperthermia and chemotherapy. Methods: Eighteen cases of malignant tumor patients underwent total body hyperthermia with infrared radiation on body surface under the general anesthesia with static suction for 20 times. Traumatic monitoring of hemodynamics, pulmonary oxygenation indicators, determination of electrolytes, blood glucose and urine output. Results: The heart rate and central venous pressure increased during the warm-up and isothermal periods. The mean arterial pressure, partial pressure of arterial carbon dioxide, arterial blood pH, BE, serum potassium and blood glucose decreased, and recovered during the cooling-off period. Conclusion: Static suction combined with general anesthesia, invasive monitoring of hemodynamics, to correct the imbalance of the internal environment and maintain the stability of cardiorespiratory function is the key to systemic hyperthermia anesthesia.