硬膜外镇痛对术后心肌缺血的影响  

Effects of Epidural Analgesia on Postoperative Myocardial Ischemia

作　　者：雷军[1] 谭晓红[1] 董击夫[1] 熊冠泽[1] 

机构地区：[1]四川省肿瘤医院,四川成都市610041

出　　处：《职业卫生与病伤》2005年第4期264-266,共3页Occupational Health and Damage

摘　　要：目的探讨硬膜外镇痛对术后心肌缺血的影响。方法将50例ASAⅡ-Ⅲ级择期食管癌切除患者,随机分为术后硬膜外镇痛组(A组,n=25)和对照组(C组,n=25)。用Datex-Ohmeda S/5多导联自动ST段分析仪检测术后ST段变化情况,求得2组患者术后心肌缺血发生率及严重程度。结果A组术后镇痛效果明显优于对照组差异有统计学意义(t=3.60,P<0.05);A组心肌缺血发生率(24%)低于C组(52%)差异有统计学意义(χ2=4.16,P<0.05);A组缺血负荷小于C组(3.4±4.8vs5.9±7.1)差异无统计学意义(t=0.85,P>0.05);2组平均ST段变化无统计学意义。结论持续硬膜外镇痛能降低术后心肌缺血发生率,但不能明显改善其缺血程度。Objective To explore the effects of epidural analgesia on postoperative myocardial ischemia. Methods Fifty postoperative patients with esophageal carcinoma were followed up. Twenty - five patients received epidural analgesia（A group）. The myocardial ischemia was detected by Datex- Ohmeda 8/5 monitor immediately after surgery and lasted for 24 hours. Incidence of postoperative myocardial ischemia and the change of ST segments were assessed. Results The efficacy of pain relief in A group was superior to that in C group（ P 〈 0.05）; Incidence of postoperative myocardial ischemia in A group was 24% and in B group was 52 %. （P〈0.05） ; There was no significant between the two groups in the change of ST segments.Conclusion The way of epidural analgesia can effectively reduce the incidence of postoperative myocardial ischemia in.

关 键 词：镇痛 硬膜外 心肌缺血 心电图 

分 类 号：R614[医药卫生—麻醉学] R655.4[医药卫生—外科学]