CAJ | 학술논문

目的了解全身热疗(Whole Body Hyperthermia WBH)治疗恶性肿瘤期间,胃粘膜二氧化碳张力(PgCO2)的变化及其临床意义.方法选择26例恶性肿瘤患者在气管插管静吸复合全麻下行全身热疗,治疗温度为41.8℃.用TONOCAPTM胃张力测定仪分别在麻醉前(Ⅰ),麻醉后30 min(Ⅱ),体温达39℃时(Ⅲ)、41.8℃时(Ⅳ),降温至38℃(Ⅴ),及体温正常后1 h(Ⅵ)测定PgCO2.同时监测记录MAP、CVP、HR、SPO2,血气分析、血常规及尿量等各项指标.结果静吸复合麻醉下全身热疗期间Pg-CO2随温度升高进行性上升,恒温及降温初期达到最高(P＜0.01),随着降温过程PgCO2随之下降.在体温降至正常后1 h,77%患者PgCO2可恢复麻醉前水平.结论全身热疗期间,随着人体温度变化,胃粘膜存在不同程度低灌注,PgCO2能较好的反映这种变化,其敏感性优于MAP、CVP及SPO2的变化.
목적 료해전신열료(Whole Body Hyperthermia WBH)치료악성종류기간,위점막이양화탄장력(PgCO2)적변화급기림상의의.방법 선택26례악성종류환자재기관삽관정흡복합전마하행전신열료,치료온도위41.8℃.용TONOCAPTM위장력측정의분별재마취전(Ⅰ),마취후30 min(Ⅱ),체온체39℃시(Ⅲ)、41.8℃시(Ⅳ),강온지38℃(Ⅴ),급체온정상후1 h(Ⅵ)측정PgCO2.동시감측기록MAP、CVP、HR、SPO2,혈기분석、혈상규급뇨량등각항지표.결과 정흡복합마취하전신열료기간Pg-CO2수온도승고진행성상승,항온급강온초기체도최고(P＜0.01),수착강온과정PgCO2수지하강.재체온강지정상후1 h,77%환자PgCO2가회복마취전수평.결론 전신열료기간,수착인체온도변화,위점막존재불동정도저관주,PgCO2능교호적반영저충변화,기민감성우우MAP、CVP급SPO2적변화.
Objective To investigate Perioperative change of gastrointramucosal CO2(PgCO2)during Whole Body Hyperthermia(WBH).Methods 26patients with advanced malignant tumor Scheduled for whole body hyperthermia therapy under general anesthesia were selected.Therapy temperature 41.8℃,PgCO2 was measured at pre-anesthesia(Ⅰ),30 minutes(Ⅱ)after anesthesia,body temperature rise to 39℃(Ⅲ)、constant temperature 41.8℃(Ⅳ)、38℃(Ⅴ)falling phase of temperature,and one hour after normal body temperature (Ⅵ),at the same time,MAP、HR、SPO2,The arterial blood oxygen tension,blood rontine and urine were measured.Results PgCO2 was significantly rising along with temperature at constant and initial falling stage(P＜0.01),PgCO2 descented at falling phase of temperature.In 77% patients.PgCO2 recoveried to pre-anesthasia.Conclusion Gastromucosal hypoperfusion related to therapy and anesthesia may occur during whole body hyperthermia;PgCO2 may be a more sensitive Variable than MAP、CVP、SPO2 for gastromucosal perfusion