摘要
目的 :通过检测单纯全麻或全麻加硬膜外阻滞病人的血清皮质醇、胰岛素、血糖浓度及血压变化 ,比较两种麻醉方法对抑制手术时应激反应的差异。方法 :将 2 5例ASAⅠ～Ⅱ级上腹部择期手术病人随机分为两组 :G组按常规方法诱导后行气管内插管全麻 ,C组先行硬膜外穿刺注药置管后再行气管内插管全麻。分别在入室、切皮后 10分钟、腹腔探查、缝合腹膜后四个时点记录血流动力学及血清皮质醇、胰岛素、血糖等各项参数。结果 :G组皮质醇在探查及关腹时均明显高于C组 ,胰岛素仅在关腹时G组高于C组 (P <0 0 5 )。血糖值G组亦高于C组。SBP在切皮、探查、关腹时G组均高于C组 30 %、2 3 %、18%。结论 :对于上腹部及危重手术 ,使用全麻加硬膜外麻醉能有效地抑制手术引起的应激反应 ,使病人在术中更为安全平稳 ,麻醉效果更为可靠。
Objective:To compare the stress response to upper abdominal surgery under general anesthesia or combined general epidural anesthesia.Method:Twenty five ASAⅠ Ⅱ patients undergoing elective upper abdominal surgery were randomly divided into two groups:group G(general anesthesia)and group C(combined general epidural anesthesia).The plasma concentration of cortisone,insulin,glucose and hemodynamics were measured before anesthesia, at 10min after incision,during exploration peritoneal cavity and closing peritoneal.Results:Cortisone was higher significantly in group G than that in group C during exploration and closing peritoneal.Insulin was higher in group G than that in group C( P< 0 05).Glucose was higher in group G than that in group C.The SBP was higher in group G than that in group C at each point(30%,23%,18%).Conclusion:Combined general epidural anesthesia can effectively attenuate stress response to upper abdominal surgery.
出处
《临床麻醉学杂志》
CAS
CSCD
2000年第10期493-494,共2页
Journal of Clinical Anesthesiology
