摘要
目的探讨全麻联合硬膜外阻滞对开胸手术患者血流动力学、炎症因子水平的影响。方法采用硬膜外阻滞复合全麻的患者设为观察组,采用单纯全麻麻醉法的患者设为对照组。比较2组患者血流动力学及炎症因子水平。结果观察组患者插管时、拔管时、拔管后10 min的MAP显著低于对照组(P<0.05),插管时、拔管时的HR显著低于对照组(P<0.05)。2组患者OLV 15、30 min时p(O_2)含量较双肺通气TLV时显著降低(P<0.05),观察组患者OLV 15、30 min时p(CO_2)含量显著高于双肺通气TLV时(P<0.05)。观察组患者麻醉维持期间安氟醚、芬太尼、维库溴铵的使用量和清醒时间显著优于对照组(P<0.05)。观察组患者术后6、24 h血清中IL-6含量显著低于对照组,IL-10含量显著高于对照组(P<0.05)。结论全麻联合硬膜外阻滞麻醉能够有效地保证患者血流动力学的稳定性,值得临床推广。
Objective To explore the influence of general anesthesia combined with epidural anesthesia on hemodynamics and levels of inflammatory factors in patients with open chest surgery. Methods The MAP Patients with general anesthesia and epidural anesthesia were selected as observation group,and patients with general anesthesia were selected as control group. Hemodynamics and levels of inflammatory factors were compared between two groups. Results The MAP levels at the time points of intubation,extubation and 10 minutes after extubation in the observation group were significantly lower than those in the control group（ P〈0. 05）,and the HR at intubation and extubation was significantly lower than that in the control group（ P〈0. 05）. Level of p（ O_2） at 15 and30 minutes of OLV reduced significantly in both groups when compared with that at TLV（ P〈0. 05）,and level of p（ CO_2） at 15 and 30 minutes of OLV increased significantly in observation group when compared with that at TLV（ P〈0. 05）. Usage of enflurane,fentanyl and vecuronium bromide as well as awaking time in the observation group were significantly better than those in the control group（ P〈0. 05）. Serum IL-6 and IL-10 levels 6 and 24 hours after operation in the observation group were significantly better than those in the control group（ P〈0. 05）. Conclusion General anesthesia combined with epidural anesthesia can effectively ensure the stability of patients＇ hemodynamics,so it is worthy of clinical promotion.
出处
《实用临床医药杂志》
CAS
2016年第7期72-74,89,共4页
Journal of Clinical Medicine in Practice
关键词
硬膜外阻滞麻醉
血流动力学
全身麻醉
动脉压
epidural block anesthesia
hemodynamics
general anesthesia
arterial pressure
