硬膜外阻滞复合全麻对非体外循环冠状动脉旁路移植术患者应激反应的影响  

Effects of thoracic epidural combined with generalanesthesia on stress response in patients undergoingoff-pump coronary artery bypass grafting

作　　者：华震[1] 尹燕伟[1] 于文刚[1] 宋健防[1] 梁永新[1] 王明山[1] 

机构地区：[1]青岛大学医学院附属医院,山东青岛266003

出　　处：《山东医药》2005年第33期7-8,共2页Shandong Medical Journal

摘　　要：目的比较单纯全麻和胸段硬膜外阻滞复合全麻对非体外循环冠状动脉旁路移植术(OPCAB)患者应激反应的影响。方法选择30例行OPCAB的患者,分别采用胸段硬膜外阻滞复合全麻及单纯全麻。手术前麻醉诱导后及手术后1、2、48h检测血浆中内皮素(ET)、白细胞介素(IL)介素-6(IL-6)、IL-8、IL-10及肿瘤坏死因子(TNE-α)的含量。结果两组血浆中ET、IL-6、IL-8、IL-10及TNE-α水平在术前差异无显著性(P>0.05);两组术后均明显升高,与麻醉诱导后相比,差异有显著性(P<0.05),但观察组明显低于对照组(P<0.05)。结论高胸段硬膜外阻滞复合全麻能明显降低OPCAB患者的应激反应。Objective： To study the Effects of thoracic epidural anesthesia combined with general anesthesia on the stress response in patients undergoing off-pump coronary artery bypass grafting. Methods： 30 patients scheduled for off-pump coronary bypass grafting were divided randomly into two groups. 15 of them were given thoracic epidural anesthesia plus general anesthesia as the study group. The others as the control group received general anesthesia only. 5ml artery blood samples were obtained before operation,at the end of operation lh, 24h and 48h after operation for determination of plasma ET, IL-6, IL-8, IL-10 and TNF-α. Results： The plasma levels of ET, IL-6, IL-8, IL-10 and TNF-α were significantly lower in the study group than those in the control group P〈0. 05. Conclusion： Compared with general anesthesia alone, thoracic epidural anesthesia combined with general anesthesia can attenuate the stress response to surgery in the patients undergoing off-pump coronary artery bypass grafting.

关 键 词：硬膜外麻醉 全身麻醉 冠状动脉旁路移植术 应激反应 

分 类 号：R614.2[医药卫生—麻醉学] R654.2[医药卫生—外科学]