全麻复合硬膜外阻滞对冠心病上腹部手术患者的影响  

Effects of combined general-epidural anesthesia in patients with coronary artery disease undergoing upper obdominal surgery

作　　者：林子波[1] 纪浩聪[1] 高晓枫[1] 

机构地区：[1]广东省惠州市中心人民医院麻醉科,惠州516001

出　　处：《临床医学》2008年第9期10-11,共2页Clinical Medicine

摘　　要：目的观察全麻复合硬膜外阻滞对冠心病上腹部手术患者血流动力学、C反应蛋白（CRP）和白细胞介素-6（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（15例）全麻复合硬膜外阻滞，B组（15例）单纯全麻。分别于麻醉开始前、气管插管5min后、手术开始1h后、术后24h抽取中心静脉血，测定C反应蛋白和IL-6，同时记录平均动脉压（MAP）、心率（HR）、每搏指数（SI）。结果术中B组MAP、HR均高于A组（P〈0．05），A组SI显著提高。术中A组CRP、IL-6无明显变化，而B组升高（P〈0．05），且B组CRP、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，更适用于冠心病患者上腹部手术。Objective To investigate the effects of combined general - epidural anesthesia on circulation and plasma level of CRP and IL -6 in patients with coronary artery disease undergoing upper obdominal surgery. Methods Thirty patients with coronary artery disease 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 ,60 min after surgery , and 1 day after surgery for determination of plasma levels of CRP, IL -6. At the same time , MAP, HR and SI were recorded. Results In group B the MAP and HR were higher than that in group A （ P 〈 0.05 ）, in group A the SI increased significantly. There were no significant difference in plasma CRP and IL - 6 in group A. In group B the plasma levels of CRP 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 CRP and IL - 6 in patients with coronary artery disease undergoing upper abdominal surgery ,being suitable for these patients.

关 键 词：全麻复合硬膜外阻滞 冠心病 CRP IL-6 上腹部手术 

分 类 号：R614[医药卫生—麻醉学]