【摘要】 目的探讨麻醉类药物异氟醚和异丙酚对乳腺癌患者的QT离散度的效果,确定异氟醚和异丙酚对心肌功能的影响。方法随机选取2015年6月至2016年6月期间于开封市肿瘤医院接受表柔吡星化疗的乳腺癌患者100例,随机分为AI、AP组,每组各50例;同时选取未接受化疗的乳腺癌患者100例,随机分为CI、CP组,每组各50例。对AI组、CI组进行1.1%~1.6%异氟醚麻醉,AP组和CP组则进行异丙酚麻醉。以T1、T2、T3、T4、T5~T8、T9各时间点分别表示记录化疗前、化疗后第2周、气管插管前、即刻插管后、全麻给药后5、10、15、20 min、拔除气管导管10 min时各点的变化情况并记录QT间期(QTc)和QT间期延长的情况;在T1~7时进行QT离散度的较正后(QTcd)的计算。结果 AI组的T5~7时比T2的QT间期延长(P<0.05);AI组比AP组、CI组和CP组的T5~7时QT间期长(P<0.05)。在AI组和AP组中,T2~7时比T1时的QT离散度增加(P<0.05);AI组中T5~7时比T2时QT离散度增加(P<0.05)。QT间期延长发生率:在T6~8时,AI组比AP组、CI组和CP组的QT间期延长的发生率大(P<0.05)。结论接受表柔吡星作为辅助化疗手段的乳腺癌患者中QTcd可能会增加,异氟醚致使放大QT离散度并拉长QT间期,异丙酚对其没有明显影响。更多还原

【Abstract】 Objective To investigate the effect of isoflurane and propofol on QT dispersion in patients with chemotherapy refractory epirubicin- induced breast cancer,and determine the effect of isoflurane and propofol on myocardial function.Methods 100 cases of patients were randomly selected from June 2015 to June 2016,and were divided into group AI and group AP,each group of 50 patients;100 patients without chemotherapy were randomly divided into CI,CP groups,each group of 50 cases. The AI group and CI group were given 1.1% and 1.6% isoflurane anesthesia,respectively;AP group and CP group received propofol anesthesia. Changes were recorded before and second weeks after chemotherapy,before tracheal intubation,immediately after intubation and general anesthesia after administration of 5,10,15,and 20 min,and extubation10 min. QT interval and QT interval prolongation were recorded,and QT dispersion was calculated(QTcd)and normalized at T1~7. Results T5~7group AI was longer than the QT T2 interval prolongation(P<0.05). The QT time interval length of T5~7of AI group when compared with those of AP group,CI group and CP group were significantly different(P<0.05). In AI group and AP group,T2~7was significantly higher than that of QT in T1(P<0.05),and T5~7in AI group was significantly higher than QT in T2group(P<0.05). Incidence of QT interval prolongation at T6~8of AI group was significantly higher than those of AP group,CI group and CP group(P<0.05). Conclusions QTcd may be increased in patients with breast cancer receiving epirubicin as adjuvant chemotherapy,with isoflurane resulting in an increase in QT dispersion and a prolonged QT interval,but there was no significant effect of propofol.更多还原