全麻复合硬膜外阻滞对老年上腹部手术患者应激和循环的影响  

Combined General-epidural Anesthesia Reduces the Influence of Circulation and Stress in Elderly Patients Undergoing Upper Abdominal Surgery

作　　者：黄丽霞[1] 纪浩聪[1] 高晓枫[1] 

机构地区：[1]惠州市中心人民医院麻醉科,广东惠州516001

出　　处：《江西医学院学报》2006年第2期125-127,共3页Acta Academiae Medicinae Jiangxi

摘　　要：目的观察全麻复合硬膜外阻滞对老年上腹部手术患者血流动力学、血糖、皮质醇和IL-6的影响。方法30例老年上腹部手术患者ASAⅠ-Ⅱ级，随机分为A、B两组，A组全麻复合硬膜外阻滞，B组单纯全麻，分别于麻醉开始前、气管插管5rain后、手术开始1h后、术后24h抽取中心静脉血，测定血糖（Glu）、皮质醇（Cor）和IL-6，同时记录BP、HR。结果术中B组血压、心率均高于A组（P〈0．05），术中A组血糖、皮质醇、IL-6无明显变化，而B组升高（P〈0．05），且B组血糖、皮质醇、IL-6均高于A组（P〈0．05）。结论全麻复合硬膜外阻滞可明显抑制应激反应，更适用于老年上腹部手术。Objective To investigate the effects of combined general-epidural anesthesia on circulation and plasma level of Glu,Cor and IL-6 in elderly patients undergoing upper obdominal surgery. Methods Thirty elderly patients undergoing upper obdominal surgery were randomly divided into 2 groups： group A （n= 15） receiving combined general-epidural anesthesia, group B receiving general anesthesia alone. Blood samples were taken via internal jugular vein before anesthesia, at 5 min after anesthesia,60min after surgery,and 1 day after surgery for determination of plasma levels of Glu,Cor,IL-6. At the same time, BP and HR were recorded. Results In group B the BP and HR were higher than that in group A（P〈0.05）. There were no significant difference in plasma Glu,Cor and IL-6 in group A. In group B the plasma levels of Glu,Cor and IL-6 were all signigicantly higher than that in group A（P〈0.05）. Conclusion Combined general-epidural anesthesia could reduce the influence of plasma Glu,Cor and IL-6 in elderly patients undergoing upper abdominal surgery,being suitable for these patients.

关 键 词：全麻复合硬膜外阻滞 上腹部手术 循环和应激反应 老年 

分 类 号：R614[医药卫生—麻醉学] R656[医药卫生—外科学]