摘要：

目的：探讨口咽癌同期行皮瓣移植修复手术的麻醉血流动力学监测。方法：回顾性分析我院2018年1月至2022年9月口咽癌同期行皮瓣移植修复手术患者的32例围手术期麻醉资料，术中连续监测心率（heart rate，HR）、有创动脉压（invasive arterial blood pressure，IBP）、中心静脉压(central venous pressure，CVP)、血氧饱和度（blood oxygen saturation，SPO₂)、pH值、动脉血氧分压(partial pressure of oxygen，PaO₂)、二氧化碳分压( partial pressure of carbon dioxide，PaCO₂)、麻醉时间、出血量、围术期麻醉相关并发症。分别记录麻醉开始(T1)、手术开始(T2)、移植修复开始 (T3)、移植修复后(T4)和手术结束(T5)共5个时间节点的数值。结果：32例麻醉均顺利完成，麻醉时间为（490.84±15.04）min，出血量为（385.62±4.32）mL；T3时的IBP、CVP明显低于其他各节点，HR明显高于其他各节点(P<0.05)；T4、T5 时的pH值低于其他节点，PaCO₂高于其他节点(P<0.05)；围术期无麻醉相关并发症。结论：口咽癌同期行皮瓣移植修复手术的麻醉血流动力学监测中，术中应重点监测麻醉时间、麻醉深度及出血量，并维持麻醉过程中的循环稳定及酸碱平衡。

关键词: 口咽癌, 皮瓣移植, 围术期, 麻醉血流动力学

Abstract:

Objective: To investigate the anesthesia hemodynamic monitoring of simultaneous flap transfer for oropharyngeal carcinoma. Methods: The perioperative anesthesia data of 32 patients with oropharyngeal carcinoma who underwent pedicle flap transplantation and carcinoma excision at the same time in our hospital from January 2018 to September 2022 were retrospectively analyzed. Heart rate (HR), invasive arterial blood pressure (IBP), central venous pressure (CVP), blood oxygen saturation (SPO₂), pH value, partial pressure of oxygen (PaO₂), partial pressure of carbon dioxide (PaCO₂), anesthesia time, blood loss, and perioperative anesthesia related complications were continuously monitored during the operation. The data were recorded at the beginning of anesthesia (T1), the beginning of surgery (T2), the beginning of flap transfer (T3), the end of flap transfer (T4) and the end of surgery (T5).Results: Anesthesia was successfully performed in 32 cases. The anesthesia time was (490.84±15.04) min, and the blood loss was (385.62±4.32) mL. IBP and CVP at T3 were significantly lower than those at other time points, and HR was significantly higher than those at other time points (P<0.05). At T4 and T5, pH value was lower than those at other time points, and PaCO₂ was higher than those at other time points (P<0.05). There were no complications related to anesthesia during the perioperative period. Conclusion: In the anesthesia hemodynamic monitoring of simultaneous pedicle flap transplantation for oropharyngeal carcinoma excision, it is important to monitor the anesthesia time, depth of anesthesia and blood loss, and maintain the circulation stability and acid-base balance during anesthesia.

Key words: oropharyngeal carcinoma, pedicled flap transfer, perioperative, hemodynamics of anesthesia

中图分类号: 

• R782

• R739.8