硬膜外阻滞及不同全麻诱导药物对血浆血栓素B_2和6-酮-前列腺素F_(1α)的影响  

THE INFLUENCE OF EPIDURAL ANESTHESIA AND DIFFERENT GENERAL ANESTHETIC AGENT ON THROMBOXANE B_2 AND 6-keto-PROSTAGLANDIN F_(1α)

作　　者：刘慧贞[1] 李刚[1] 许永广[1] 

机构地区：[1]山东省立医院麻醉科

出　　处：《山东医科大学学报》2001年第5期442-443,446,共3页Acta Academiae Medicinae Shandong

摘　　要：目的 :探讨硬膜外阻滞及不同全麻诱导药物对血浆血栓素B2 (TXB2 )和 6 酮 前列腺素F1α浓度的影响。方法 :选择腹部手术患者 4 2例 ,随机分为 3组 :硬膜外麻醉组 (1组 ) ,硫喷妥钠诱导全麻组 (2组 ) ,异丙酚加咪唑安定诱导全麻组 (3组 ) ,每组又随机分为A、B两组。于麻醉诱导前及诱导后 15～ 2 0min(A组为手术切皮前 ,B组为切皮 5～ 10min) ,查血浆血栓素B2 (TXB2 )、6 酮 前列腺素F1α(6 keto PGF1α)、T/K。结果 :1组TXB2 诱导前后及切皮前后无差异 ;2组切皮后血浆TXB2 浓度较诱导前及切皮前均显著升高(P <0 0 5 ) ;3组TXB2 诱导后较诱导前及切皮后均显著降低 (P <0 0 5 ) ;切皮后 3B组TXB2 较 2B组显著下降 (P <0 0 5 )。结论 :血浆TXB2 浓度在手术应激中明显升高 ,硬膜外麻醉对其有一定抑制作用 ,异丙酚和咪唑安定可以明显降低TXB2 浓度。Objective:To observe the influence of epidural anesthesia and different general aneshthetic agent on plasma thromboxane B 2(TXB 2) and 6-keto-prostaglandin F 1α (6-keto-PGF 1α concentration before and during surgery.Methods:42 patients undergoing elective abdominal surgery were allocated randomly in three groups:epidural anesthesia(group1, n =14),general anesthesia induced with thiopental (group2, n =14),general nesthesia induced with propofol and midazolam(group 3, n =14).Every group was also allocated randomly in group A( n =7) and group B( n =7).Venous blood samples were collected at two time:before anesthesia and 15～20 minute after anesthesia(group A were before skin incision,group B were 5～10 minute after skin incision).Results:In group 2,plasma (TXB 2) concentration significantly increased from(179.8±44.0) pg.ml -1 to ( 268.7±92.9)pg.ml -1 after skin incision( P<0.05). PlasmaTXB 2 after skin incison was also significant higher than before skin incison( P<0.05). In group 3,plasma thromboxane B 2(TXB 2) concentration significantly decreased from(168.4±79.7)pg.ml -1 to (108.8±43.9)pg.ml -1 after anesthesia ( P<0.05), plasmaTXB 2 level before skin incison were lower than after skin incison( P<0.05). After skin incison,TXB 2 was higher in group 2 than in group 3( P<0.05). Conclusion:Plasma TXB 2 concentration is increased during surgical stress,which is inhibited by epidural anesthesia in some degree.Propofol and midazolam siginficantly decreases TXB 2 level.

关 键 词：硬膜外麻醉 全身麻醉 前列腺素F 血栓烷B2 6-keto-PGF12 

分 类 号：R614.42[医药卫生—麻醉学] R971.2[医药卫生—外科学]