安氟醚麻醉下牵拉胆囊对家兔血流动力学的影响及机理探讨  

The study on effect and mechanism of enflurne to rabbits hemodynamics on the pulling gallbladder

作　　者：方开云[1] 安裕文[1] 王洋[2] 高鸿[1] 

机构地区：[1]贵阳医学院附院,550004 [2]贵阳市第四人民医院,550001

出　　处：《贵州医药》2003年第1期18-20,共3页Guizhou Medical Journal

摘　　要：目的研究安氟醚麻醉下牵拉胆囊对家兔血流动力学的影响 ,并初步探讨其机理。方法健康家兔 2 4只 ,动物随机分为A、B、C三组 ,A组对照组 (n =8) ,B组 0 6 5MAC安氟醚 ,C组1 3MAC安氟醚。暴露胆囊 ,坠以 10 0g重物牵引 10分钟。于牵拉前、牵拉时、牵拉结束后 10分钟、牵拉结束后 30分钟测定心率 (HR)、平均动脉压 (MAP)、中心静脉压 (CVP)、左心室收缩压 (LVSP)、左心室压力微分 (±dp/dtmax、±dp/dt)。最后迅速开胸 ,取冠状窦静脉血测全血乙酰胆碱 (Ach)、取心肌组织测定肾上腺素 (E)、去甲肾上腺素 (NE)。结果C组除CVP外 ,其余各项指标均明显下降 ,与A组比较差异有显著性 (P <0 0 5 ) ,±dp/dtmax、+dp/dt与B组比较 ,差异也有显著性 (P <0 0 5 )。牵拉时 ,各组与牵拉前比较 ,HR均明显减慢 ,MAP、LVSP、±dp/dtmax、±dp/dt降低 (P <0 0 5或P <0 0 1)。其中C组与A组、B组比较LVSP、±dp/dtmax、±dp/dt降低 (P <0 0 5或P <0 0 1)。B组、C组的Ach、低于A组 (P <0 0 5 )。C组的E低于A组、B组 (P <0 0 5 )。结论 1 牵拉胆囊可抑制心肌收缩力。 2 安氟醚麻醉可加重牵拉胆囊对心肌收缩力的抑制作用。 3 胆系手术时应慎重选择适合病人情况的安氟醚吸入浓度 。Objective To study the effects of pulling gallbladder on hemodynamics and mechanism during enflurne anesthesia. Methods Twenty four rabbits were divided randomly into three groups (n=8):control group (group A), 0.6MAC enflurane (group B), 1.3MAC enflurane (group C). The gallbladder was exposed and pulled for ten minutes by 100g object. Heart rate(HR) ?mean artery pressure (MAP) ?central vein pressure(CVP) ?left ventricle stroke pressure(LVSP) ?left ventricular developing pressure (±dp/dtmax ?±dp/dt) were recorded at prepulling?pulling?postpulling 10 minutes and postpulling 30 minutes. The actylcholine(Ach) of coronaria vein blood and the repinephring(E) ? norepinephring(NE) of heart muscle were measured. Results Group C caused significantly difference ( P <0.05) in the all parameters than group A except for CVP, and caused significantly difference ( P <0.05) in the ± dp/dtmax?±dp/dt than group B The compared with group A and group B that group C caused significantly difference on the LVSP?±dp/dtmax?±dp/dt during pulling ( P <0.05 or P <0.01). group B and group C caused obviously depression of Ach ( P <0.05). The depression of E produced by group C was significantly than it in other groups ( P <0.05). Conclusion 1.Pulling gallbladder can inhibited cardiovascular function. 2.Enflurane can aggravated of cardiovascular function when pull gallbladder.3.It is important that use suitable enflurane concentration and reinforce monitor for patients who undergo operation of cholecystectomy.

关 键 词：麻醉 安氟醚 牵拉胆囊 血流动力学 动物实验 

分 类 号：R657.4[医药卫生—外科学] R971.2[医药卫生—临床医学]