静脉快通道麻醉联合硬膜外阻滞对老年患者血浆ET及CGRP的影响  

Effect of intravenous fast-track anesthesia combined with epidural block on plasma ET and TXB2 in elderly patients

作　　者：梁华[1] 栾瑞[1] 丁志刚[1] 刘晓华[1] 袁利邦[1] 周建民[1] 

机构地区：[1]解放军第五医院麻醉手术科,宁夏银川750004

出　　处：《西北国防医学杂志》2015年第1期1-4,共4页Medical Journal of National Defending Forces in Northwest China

基　　金：宁夏回族自治区科技攻关计划资助项目(20112YS274)

摘　　要：目的：观察静脉快通道联合硬膜外麻醉对老年患者上腹部手术围手术期血浆内皮素（ET）及降钙素基因相关肽（CGRP）的影响。方法：68例择期行胃癌根治术患者,年龄（66.45±7.36）岁,ASAⅠ~Ⅱ级,随机分两组,各34例。A组：单纯静脉快通道全麻,B组：静脉快通道麻醉联合硬膜外阻滞。不同时间点采集静脉血测定血浆ET、CGRP含量,同时观察血流动力学变化。结果：ET：各时点两组与麻醉前比较略有降低,但无显著差异（P〈0.05）,组间比较无显著差异（P〈0.05）。CGRP：两组插管后5min均开始升高,切皮后5min显著增高（P〈0.05）,术毕拔管后达峰值,组内各时点与术前比较差异显著（P〈0.05）,组间各时点比较差异显著（P〈0.05）,A组T2、T3、T4时点明显低于B组（P〈0.05）,而B组均高于麻醉前（P〈0.05）。结论：静脉快通道联合硬膜外麻醉对老年上腹部手术患者血浆ET和CGRP的调控优于静脉全麻。Objective：To observe the effect of intravenous fast-track anesthesia combined with epidural block in elderly patients undergoing upper abdominal operation on the plasma content of endothelin（ET）and calcitonin gene-related peptide（CGRP）in peroperative period.Methods：A total of 68 elderly patients undergoing radical gastrectomy,ASA Ⅰ-Ⅱ,were randomly divided into two groups：Group A（n=34,intravenous fast-track anesthesia）and group B（n=34,intravenous fast-track combined with epidural anesthesia）.The peripheral venous blood samples were taken at different time points to test the plasma level of ET and CGRP with radioimmunoassay,and the hemodynamic changes were observed.Results：Compared with before anesthesia,the ET in both groups was decreased slightly at each time points,but no significant difference（P0.05）,and there was no obvious difference in ET level between two groups（P0.05）.The CGRP in both groups began to increase 5minutes after intubation,and was obviously increased5 minutes after skin incision（P0.05）,and reached the peak after extubation.There was significant difference in CGRP within each group between at each time points and before surgery（P0.05）.The CGRP at T2,T3 and T4time points in group A was markedly lower than that in group B（P0.05）.In group B,there was obvious difference in CGRP between before anesthesia and at each time points after anesthesia（P0.05）.Conclusion：The intravenous fast-track anesthesia combined with epidural block is superior to the intravenous fast-track anesthesia only for regulating the secretion of plasma ET and CGRP in elderly patients undergoing upper abdominal operation.

关 键 词：麻醉学 静脉快通道 硬膜外 内皮素 降钙素基因相关肽 老年人 

分 类 号：R614[医药卫生—麻醉学]