硬膜外阻滞复合全麻对冠心病上腹部手术患者循环功能及心率变异性的影响  

Influence of Combined General-epidural Anesthesia on the Circulation Function and Heart Rate Variability in Patients with Coronary Heart Disease Undergoing Epigastric Surgery

作　　者：姚胜昔 

机构地区：[1]湖南省沅江市人民医院麻醉科,湖南浏阳413100

出　　处：《中国医药指南》2011年第11期20-22,共3页Guide of China Medicine

摘　　要：目的探讨硬膜外阻滞复合全麻对冠状动脉粥样硬化性心脏病(冠心病)上腹部手术患者循环功能及心率变异性的影响。方法 62例冠心病上腹部手术患者随机分为两组:全麻组(A组,n=31)和全麻复合硬膜外组(B组,n=31),利用心率变异功率谱分析法对麻醉前、插管时、切皮时及拔管时循环功能及心率变异性改变进行分析。结果银屑病患者皮损处GF-α、VEGF的表达及MVD值显著高于正常对照组(P<0.01);银屑病患者皮损中的TGF-α、VEGF表达与MVD呈正相关(r=0.672,r=0.735,均P<0.01),TGF-α与VEGF的表达也呈正相关(r=0.821,P<0.05)。结论银屑病患者皮损中TGF-α、VEGF及MVD的表达水平均增高,表明TGF-α及VEGF可能引起银屑病患者皮损处血管增生,三者在银屑病皮损的形成发展过程中可能发挥协同促进调节作用。Objective To explore the influence of combined general-epidural anesthesia on the circulation function and heart rate variability in patients with coronary heart disease undergoing epigastric surgery.Methods 62 patients with coronary heart disease undergoing epigastric surgery were randomLy divided into two groups： received general anesthesia group（A group,n=31） and received combined general-epidural anesthesia group（A group,n=31）.The circulation function and heart rate variability were assessed before anesthesia,during Intubation,during skin incision and during extubation,respectively.Results The expression of TGF-α,VEGF and MVD in psoriasis vulgaris tissue group were signifcantly higher than those in the normal group（P0.05）.The expression of TGF-α,VEGF were positively correlated with MVD levels in psoriasis vulgaris tissue group（r=0.672,r=0.735,all P0.01）,the expression of TGF-α was also positively correlated with VEGF（r=0.821,P0.01）.Conclusion The expression is increased of.TGF-α,VEGF and MVD inpsoriasis vulgaris lesions,they may play positive roles in regulating and facilitating synergy in the lesion specimens of psoriasis.

关 键 词：硬膜外阻滞 全身麻醉 冠心病 心率变异性 

分 类 号：R541.4[医药卫生—心血管疾病]