摘要
目的:分析全麻复合硬膜外麻醉对非体外循环冠状动脉搭桥(OPCAB)术中循环功能及及心肌酶变化的影响。方法:30例择期行非体外循环冠脉搭桥术病人按随机分为两组:观察组为高位胸段硬膜外阻滞复合全麻;对照组为单纯全麻,在麻醉诱导前(T0)、术后1 h(T1)、24h(T2)、48 h(T3)4个时间点抽取血样测定cTnI、CK、CK-MB值并记录血流动力学指标。结果:所有病人手术经过及术后恢复顺利,无1例转为体外循环。术前两组间各项指标差异均无统计学意义(P>0.05)。但术后观察组血压、心率较对照组为平稳。对照组病人术后血压、心率均较观察组明显升高(P<0.05);两组术后各时点CK、CK-MB、cTnI均较术前明显升高(P<0.05)。与对照组相比,观察组术后各时点明显降低(P<0.05)。观察组气管拔管时间I、CU停留时间及术后住院天数均较对照组明显缩短。结论:硬膜外复合全麻可以使循环功能稳定,为OPCAB围术期心肌提供良好保护作用。
Objective：To investigate the effect of thoracic epidural anesthesia on hemodynamie parameters and the changes of eardiae troponin Ⅰ （eTnⅠ）,ereatine kinase （CK）and ereatine kinase-MB（CK-MB） aetivities in serum during off-pump eoronary artery by pass grafting （OPCABG）.Methods：Thirty ASA Ⅱ- Ⅲ patients undergoing OPCABG were divided randomly into two groups, 15 of whieh were given thoraeie epidural anesthesia plus general anesthesia as the study group.The others as the eontrol group reeeived general anesthesia only. Hemodydemie parameters ineludig MAP and HR were reeorded.Serum samples were eolleeted before operation, at the end of operation lh ,24h ,and 48h for determination of CK,CK-MB,eTnI aetivities. Results：The data of two groups obtained before the operation had no differenee.But MAP and HR in the study group were signifieantly stable eompared with those in the eontrol group after operation; CK,CK-MB and eTnI aeivities at 1 hour,24 hours,48 hours after operation in two groups were signifieantly higher than those before operation（P〈0.01）. CK,CK-MB and eTnI aeivities in study group at 1 hour,24 hours,48 hours after operation were signifieandy higher than those before operation in the eontrol group （P〈0.05）. Conclusion：Thoraeie epidural anesthesia ean maintain stable hemodynamies and make a better preservation for patients during perioperative period of OPCAB.
出处
《现代医药卫生》
2007年第24期3635-3637,共3页
Journal of Modern Medicine & Health
