腰麻对老年人围手术期血清肌钙蛋白T的影响  

Effect of spinal anesthesia on serum troponin T in the elderly patients during the perioperation

作　　者：张舟[1] 张长椿[1] 吴萍[1] 陈信发[1] 郑良杰[1] 

机构地区：[1]汕头市中心医院麻醉科,广东省汕头515031

出　　处：《中国基层医药》2009年第3期484-486,共3页Chinese Journal of Primary Medicine and Pharmacy

基　　金：广东省汕头市重点科技计划项目（汕府[2006]82号）

摘　　要：目的 观察蛛网膜下腔阻滞麻醉（腰麻）对老年患者围手术期血清肌钙蛋白T（TN-T）的影响，探讨其应用于冠心病患者的安全性。方法40例老年患者依术前有无冠心病史分为两组，每组20例，Ⅰ组为有冠心病组，Ⅱ组为无冠心病组。两组患者均采用单次腰麻复合硬膜外联合麻醉，分别于麻醉前、手术结束时和术后24h采集血样，应用罗氏电化学发光全自动免疫分析仪E170检测血清TN-T含量，观察患者有无冠心病发作症状及体征，记录患者的年龄、手术时间、麻醉平面、出血量，监测心电图、血压、心率、脉搏血氧饱和度。结果两组患者的年龄、手术时间、麻醉平面、出血量、输液量、血压、心率、脉搏血氧饱和度等差异无统计学意义，两组患者组内各时点血样TN-T差异无统计学意义，两组患者未发现冠心病发作症状体征。Ⅰ组与Ⅱ组各时点TN—T检验阳性率为5％、5％、20％，构成比差异元统计学意义。两组患者均有1例麻醉前TN-T〉0．010μg／L，手术过程及术后TN-T均高于参考值，患者无不适。结论腰麻对老年冠心病患者围手术期血清肌钙蛋白T无明显影响。Objective To explore the security of spinal anesthesia by observing the perioperation serum troponin T in the elderly patients with coronary heart disease who underwent spinal anesthesia. Methods 40 cases were divided into two groups according to the elderly patients with or without the history of coronary heart disease. Group Ⅰ of 20 cases were the patients with the history of coronary heart disease. Group Ⅱ of 20 cases were the patients without the history of coronary heart disease. Both groups were undertaken single spinal anesthesia combined with epidural anesthesia. The blood samples were collected at the time of perioperation, the end of the operation and 24 hours after surgery. The serum troponin T was tested by Roche fully automated chemilumineseent analyzer El70. The symptoms and signs of the eoronary heart disease in the patient were observed. And the age, operation time, anesthesia lever, the amount of bleeding and transfusion were recorded, and at the same time, electrocardiogram, heart rate, pulse, cerebral oxygen saturation were monitored. Results There was no significant difference between two groups in age, operation time, anesthesia lever, the amount of bleeding and transfusion, heart rate, pulse, eerebral oxygen saturation. There was no significant difference between two groups in serum troponin T. No symptoms and signs of the coronary heart disease were observed in two groups. There was no significant difference between two groups in constituent ratio of positive rate of serum troponin T. There was one case in each group that serum troponin T was more than reference value （0. 010μg/L） during the pefioperation while the patient was no discomfort. Conclusion Spinal anesthesia has no impact on the change of perioperative serum troponin T in the elderly patients with coronary heart disease.

关 键 词：麻醉 脊椎 肌钙蛋白T 老年人 

分 类 号：R614[医药卫生—麻醉学]