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目的观察气管内插管全麻在支气管肿瘤冷冻术中的麻醉效果并评价其安全性。方法选择2012年6月至2013年9月收治的78例支气管肿瘤患者,随机分为气管内插管全麻组(观察组)和静脉镇静加气管内表面麻醉组(对照组),观察两组患者不同时间段平均动脉压(MAP)、心率(HR)以及氧分压(SO2)水平的变化,并评价各种方法的安全性。手术后3个月和6个月时进行随访,并采用健康测量量表(SF-36)进行生活质量评定。结果两组患者的MAP、HR水平在麻醉前(T0)比较,差异无统计学意义(P>0.05);观察组患者的MAP和HR水平在冷冻开始前(T1)、冷冻开始后30 min(T2)、冷冻结束时(T3)均低于对照组,差异有统计学意义(P<0.05);两组患者的SO2水平在各时间节点比较,差异均无统计学意义(均P>0.05)。两组患者术后的血常规及肝肾功能检测均未见异常。观察组患者无不良反应,对照组患者发生不良反应20例(51.3%),差异有统计学意义(P<0.01)。在术后3个月和6个月时,观察组患者的生活质量指标生理机能(PF)、生理职能(RP)和情感职能(RE)评分均高于对照组,差异有统计学意义(P<0.01)。结论支气管肿瘤冷冻术中应用气管内插管全麻麻醉效果更佳,且安全性高,有利于提高患者术后生活质量。
Objective To observe the anesthetic effects of endotracheal intubation general anesthesia in bronchial neoplasms and to evaluate its safety. Methods A total of 78 patients with bronchogenic carcinoma who were admitted to our hospital from June 2012 to September 2013 were randomly divided into general anesthesia group (observation group) and intravenous sedation plus tracheal tube anesthesia group (control group) The changes of mean arterial pressure (MAP), heart rate (HR) and oxygen partial pressure (SO2) in different time periods were evaluated and the safety of each method was evaluated. Follow-up was performed at 3 months and 6 months after surgery, and the quality of life was assessed using the Health Measurement Scale (SF-36). Results There was no significant difference in MAP and HR levels between the two groups before anesthesia (T0) (P> 0.05). The levels of MAP and HR in the observation group before the start of freezing (T1) and 30 min after the start of freezing (P <0.05). There was no significant difference in SO2 levels between the two groups at all time points (all P> 0.05), and the differences were statistically significant . Two groups of postoperative blood tests and liver and kidney function tests were normal. There were no adverse reactions in the observation group and 20 cases (51.3%) in the control group, the difference was statistically significant (P <0.01). At 3 months and 6 months after operation, the scores of physical function (PF), physiological function (RP) and emotional function (RE) in the observation group were higher than those in the control group, and the difference was statistically significant (P <0.01). Conclusion Intra-endotracheal intubation anesthesia is more effective and safe in bronchial tumor cryosurgery, which is beneficial to improve postoperative quality of life.