全麻复合硬外麻对心血管病患者上腹部手术应激的影响  

Effects of general anesthesia combined with epidural block on patients with cardiovascular diseases undergoing upper abdominal operation

作　　者：黄志良[1] 郑昭平[1] 杨文科[1] 

机构地区：[1]广东省揭阳市人民医院麻醉科,广东揭阳522000

出　　处：《海南医学院学报》2007年第1期25-27,共3页Journal of Hainan Medical University

摘　　要：目的：观察全麻复合硬外麻对高血压、冠心痛患者上腹部手术血流动力学、血糖、皮质醇和IL26的影响。方法：40例高血压、冠心痛上腹部手术患者ASAI2～3级，随机分为A、B两组，每组20例。A组全麻复合硬外麻，B组单纯全麻，分别于麻醉开始前、气管插管5min后、手术开始1h、术毕24h抽取非输液静脉血，测定血糖（Glu）、皮质醇（Cor）和IL26，同时记录BP、HR。结果：术中A组血压、心率与B组比较有显著性差异（P〈0．05），A组血糖、皮质醇、IL26无明显变化（P〉0．05），而B组升高（P〈0．05），且B组血糖、皮质醇、IL26均高于A组（P〈0．05）。结论：全麻复合硬外麻可明显抑制应激反应，适用于高血压、冠心病患者上腹部手术。Objective： To observe the changes, included hemodynamics, blood glucose, hydrocortisone and IL-26, of general anesthesia combined with epidural block on patients with hypertension and cardiovascular diseases undergoing upper abdominal operation. Methods：Forty patients with hypertension and coronary artery disease, ASAI 2- 3, were grouped randomly into A and B, each had 20 of them. The patients in group A and B were subjected to general anesthesia combined with epidural block and general anesthesia, respectively. Venous blood samples taken before the start of anesthesia, 5 min later of tracheal intubation, at 1 and 24 hour after surgery were for detection of Glu, Cor and IL- 26. Blood pressure and heart rate were recorded simultaneously. Results： BP and HR during operation were different between group A and B （P〈0.05）. These markers, included GLU, Cor and IL-26,had differences between the two groups. Conclusion： General anesthesia combined with epidural block could reduce stress reaction. It is reliable on the upper abdominal operation for patients with hypertension and coronary artery disease.

关 键 词：高血压 冠状动脉疾病 麻醉 全身 麻醉 硬膜外 外科手术 

分 类 号：R614.2[医药卫生—麻醉学]