CAJ | 학술논문

目的：探讨Narcotrend在腹腔镜辅助下胃肠癌根治术术中持续循环腹腔热灌注化疗的麻醉管理。方法：筛选2013年3月-2014年11月本院收治的行胃肠癌根治术并术中持续循环腹腔热灌注化疗患者40例作为研究对象。采用随机数表法将其分为观察组与对照组，每组20例，对照组根据麻醉医生临床经验判断实施麻醉，观察组患者采用Narcotrend麻醉深度监测仪指导实施麻醉，比较两组患者各时期患者血流动力学指标及麻醉效果。结果：观察组患者手术时间、麻醉时间与对照组比较差异无统计学意义，但麻醉药物剂量、苏醒时间等明显优于对照组，比较差异具有统计学意义（P<0.05）。对照组T2、T3、T4、T5较T0时刻SBP、DBP及HR升高（P<0.05）。两组患者T0及T1期SBP、DBP、HR比较差异无统计学意义，但对照组T2、T3、T4、T5时刻SBP、DBP、HR指标高于观察组，比较差异具有统计学意义（P<0.05）。结论：对胃肠癌根治术术中持续循环腹腔热灌注化疗患者采用Narcotren麻醉深度监测仪指导实施麻醉，可以更好的维持患者血流动力学稳定，使用较少的麻醉药物达到更好的麻醉效果，有利于患者的苏醒，具有临床应用及推广价值。
목적：탐토Narcotrend재복강경보조하위장암근치술술중지속순배복강열관주화료적마취관리。방법：사선2013년3월-2014년11월본원수치적행위장암근치술병술중지속순배복강열관주화료환자40례작위연구대상。채용수궤수표법장기분위관찰조여대조조，매조20례，대조조근거마취의생림상경험판단실시마취，관찰조환자채용Narcotrend마취심도감측의지도실시마취，비교량조환자각시기환자혈류동역학지표급마취효과。결과：관찰조환자수술시간、마취시간여대조조비교차이무통계학의의，단마취약물제량、소성시간등명현우우대조조，비교차이구유통계학의의（P<0.05）。대조조T2、T3、T4、T5교T0시각SBP、DBP급HR승고（P<0.05）。량조환자T0급T1기SBP、DBP、HR비교차이무통계학의의，단대조조T2、T3、T4、T5시각SBP、DBP、HR지표고우관찰조，비교차이구유통계학의의（P<0.05）。결론：대위장암근치술술중지속순배복강열관주화료환자채용Narcotren마취심도감측의지도실시마취，가이경호적유지환자혈류동역학은정，사용교소적마취약물체도경호적마취효과，유리우환자적소성，구유림상응용급추엄개치。
Objective:To investigate the anesthesia management of continuous cyclic peritoneal perfusion chemotherapy in gastric cancer radical resection of Narcotrend assisted laparoscopic. Method:40 continuous cyclic peritoneal perfusion chemotherapy with gastric cancer radical resection patients from 2013 March to 2014 November in our hospital were selected as the research objects. They were randomly divided into observation group and control group,with 20 cases in each group,the control group achieved anesthesia according to the experience of anesthesia doctor’s clinical experience,the observation group was treated by Narcotrend anesthesia depth monitoring to guide the implementation, compared two groups’ each stage hemodynamic indexes and anesthesia effect. Result:The observation group’s operation time,anesthesia time had no significant differences compared with the control group,and its dosage of drugs,wake time was significantly better than the that of the control group(P<0.05),with statistical significance. The control group’s SBP, DBP and HR in T2,T3,T4,T5 had increased compared with T0 time(P<0.05),there was no significant difference between the two groups’ SBP,DBP,HR in T0 and T1 stage,but the control group’s SBP,DBP,HR in T2,T3,T4,T5 were higher than the observation group(P<0.05),with statistical significance. Conclusion:Using Narcotren anesthesia depth monitoring to guide the implementation of anesthesia in gastric cancer radical surgery can better maintain the hemodynamics of patients,it uses less anesthesia drug to achieve better anesthesia effect and is beneficial to the patients’ recovery,so it has clinical value of application and popularization.