不同麻醉方法对子宫次全切患者心钠素及应激反应的影响  

Effect of ANP and irritability respone in hysterectomy with different narcosis

作　　者：程殿臣[1] 杨瑞青[2] 

机构地区：[1]甘肃省兰州市妇幼保健院麻醉科,甘肃兰州730030 [2]甘肃省兰州市妇幼保健院妇科,甘肃兰州730030

出　　处：《中国医药导报》2011年第33期90-91,共2页China Medical Herald

摘　　要：目的:探讨腰麻和硬膜外麻醉对子宫次全切患者血浆心钠素及应激反应物质的影响。方法:40例行子宫次全切患者,随机分为腰麻组(SA,n=20),硬膜外麻醉组(EA,n=20)。两组分别于术前30 min、术毕、术后24 h采集肘静脉血各5 ml,检测各时间点血浆心钠素(ANP)、肾上腺素(AN)、皮质醇(CS)的浓度。结果:术前EA组与SA组两组间ANP、AN、CS比较差异无统计学意义(P>0.05)。ANP的血浆浓度水平两组在术后24 h均比术前升高(P<0.05)。EA组术毕时患者ANP、AN、CS的浓度分别为(62.1±15.0)、(97.1±29.4)、(209.8±80.6)ng/L,明显低于SA组[(61.4±17.0)、(157.4±43.0)、(286.6±80.5)ng/L]的浓度水平(P<0.05);术后24 h患者ANP、AN、CS的浓度分别为(103.4±21.3)、(66.7±20.1)、(140.5±50.2)ng/L,明显低于SA组[(100.2±20.8)、(102.1±29.5)、(250.9±80.1)ng/L]的浓度水平(P<0.05)。结论:EA+强化麻醉可提高机体应激反应效应和心血管反应,对患者术后恢复具有积极作用。Objective： To study the spinal and epidural anesthesia for hysterectomy patients with plasma atrial natriuretic peptide and cut the material impact of the stress response.Methods： Routine hysterectomy cut 40 patients were randomly divided into two groups,the spinal anesthesia group（SA,n=20）,epidural anesthesia group（EA,n=20）.Two groups respectively collected venous blood 5 ml before surgery 30 min,surgery over,after 24 h,tested each time point of plasma atrial natriuretic peptide（ANP）,epinephrine（AN）,and cortisol（CS） concentration.Results： Before surgery EA group and SA group ANP,AN,CS had no significant differences（P0.05）.The two groups ANP plasma levels 24 h after surgery was increased than those before surgery（P0.05）.EA group when surgery over the ANP,AN,CS concentrations [（62.1±15.0）,（97.1±29.4）,（209.8±80.6） ng/L] was significantly lower than the SA group [（61.4±17.0）,（157.4±43.0）,（286.6±80.5） ng/L]（P0.05）;24 h after the patient plasma epinephrine ANP,AN,CS concentrations [（103.4±21.3）,（66.7±20.1）,（140.5±50.2） ng/L] was significantly lower than the SA group [（100.2±20.8）,（102.1±29.5）,（250.9±80.1） ng/L]（P0.05）.Conclusion： EA adding enhanced anesthesia can increase the effects of stress response and cardiovascular response,postoperative recovery of patients have a positive effect.

关 键 词：腰麻 硬膜外麻醉 心钠素 肾上腺素 皮质醇 

分 类 号：R614[医药卫生—麻醉学]