高龄患者围术期血清心肌酶及C-反应蛋白变化分析  

An analysis of changes of myocardial enzymes and C-reactive protein in serum from elder pa-tients during peri-operation

作　　者：刘健[1] 张志波[1] 刘培发 谢劲勇[1] 

机构地区：[1]91医院麻醉科,山东兖州272100

出　　处：《实用医药杂志》2002年第1期41-42,共2页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨70岁以上高龄患者在围手术期中血清心肌酶及C-反应蛋白的动态变化。方法选择ASAⅡ～Ⅲ级38例高龄患者,在异氟醚-芬太尼静吸复合麻醉下实施开胸手术时,采集肘静脉及颈外静脉血5ml,并观察术前(T0)、插管后5min(T1)、切皮后15min(T2)及拔管后5min(T3)时血流动力学、血清心肌酶及C-反应蛋白的变化情况。结果本组38例患者,血清心肌酶T3比T0显著升高(P<0.01),C-反应蛋白T2和T3与T0相比有显著差异(P<0.05),血流动力学T1、T2、T3均比与T0有不同程度的升高(P<0.05)。结论在高龄患者手术时,通过血清心肌酶及C-反应蛋白来判断心肌缺血情况,预防心绞痛、心肌梗塞的发生和发展,降低围手术期的并发症,还可以作为早期诊断心肌缺血和损伤度的敏感性指标,从而提高手术质量和降低死亡的发生率。Objective To evaluate the dynamic changes of the myocardial enzyme and C-reactive protein in serum from elder patients over70years old during peri-operation.Methods The blood sam-ples were collected from cubital vein and external ju gular vein in38patients over70years old with grade ASAⅡ～Ⅲafter combined inhalation and intravenous anesthesia with isoflurance and fentany1.The dynamic changes of hemodynamics,myocardial enzymes and C-reactive protein in serum at pre-op-eration(T0),5min after in tubation(T1),15min after in cision(T2)and5min after extubation(T3)were ob-served respectively.Results The levesl of serum myocardial enzymes were higher at T3than at T0(P<0.01).The level of C-reactive proteins was higher at T2and T3than at T0(P<0.05).The indexes of hemodynamics were higher at T1,T2and T3than at t0(P<0.05).Conclusion When the patients over70years old are operated on,the level changes of myo cardial enzymes and C-reactive protein in serum can be used to assess myocardial is chemia,for preventing angina pectoris and myocardial infarc-tion,lowering perioperative complications,as well as to diagnosing early stage myocardial ischemia,thus increasing operative quality and decreasing mortality.

关 键 词：高龄患者 静吸复合麻醉 C-反应蛋白 血清心肌酶 

分 类 号：R614.1[医药卫生—麻醉学]