术前口服苯那普利对腹腔镜气腹时血流动力学和应激反应的影响  

Effect of benazepril on the hemodynamics and stress reaction of patient with artificial pneumoperitoneum

作　　者：肖旺频[1] 方芬[1] 杜炎芳[1] 陆琪宝[1] 安尔丹[1] 

机构地区：[1]浙江省嘉兴市第二医院麻醉科,314000

出　　处：《浙江临床医学》2003年第6期418-419,共2页Zhejiang Clinical Medical Journal

摘　　要：目的 观察术前口服苯那普利对腹腔镜气腹时血流动力学和应激反应的影响。方法 32例行腹腔镜胆囊切除术 (LC)患者 ,随机分成对照组 (A组 )和实验组 (B组 ) ,两组麻醉诱导和维持方法一样 ,B组术前2h口服盐酸苯那普利0.15mg/kg。采用惠普多功能监护仪监测气腹前后血流动力学和呼气末CO2 分压的变化。用化学发光法和放免法分别检测血清皮质醇 (Cs)和血浆醛固酮 (ALD)、血管紧张素Ⅱ(AⅡ )的浓度。结果 气腹时A组心率 (HR)、收缩压 (SBP)和舒张压 (DBP)均明显增加 ,术毕恢复至气腹前水平 ,B组HR、SBP和DBP无明显变化。A组Cs、ALD和AⅡ气腹后浓度明显增加 (P<0.05) ,术毕仍未恢复原水平。B组变化不明显 (P>0.05)。结论 全麻下术前口服盐酸苯那普利施行LC ,能有效地减轻术中应激反应、稳定血流动力学 ,有利于高血压、冠心病患者的手术治疗。Objective To determine the effect of benazepril on the hemodynamics and stress reaction of patient with artificial pneumoperitoneum . Methods 32 patients who are going to accept laparoscopic cholecystectomy was randomized into two groups: group A(control group, n=16) and group B(experiment group, n=16). Same anesthesia induction and maintenance were performed on all patients, but group B took benazepril orally at a dose of 0.15mg/kg 2 hours before operation. Then the changes of hemodynamics and CO2 pressure of end expiration were detected, Cortisol, aldosterone and angiotensin Ⅱ in the plasm were examined by chemiluminescence and radio-immunity method. Result Group A showed an increase of Heart rate, systolic pressure and diastolic pressure during the operation. The plasm level of Cortisol, aldosterone and angiotensin Ⅱ of group A is significantly higher than that of group B(P>0.05). Group B showed a stable hemodynamics during the operation. Conclusion oral benazepril is effective to stabilize hemodynamics and relieve stress reaction of patient with artificial pneumoperitoneum .It is advantageous to patients with hypertension and coronary heart disease.

关 键 词：应激反应 血流动力学 术前 口服 苯那普利 腹腔镜 气腹 胆囊切除术 血清皮质醇 血浆醛固酮 

分 类 号：R657.4[医药卫生—外科学]