硬膜外阻滞对非停跳冠状动脉搭桥病人血内皮素及心钠素的影响  

Heart protection of high thoracic epidurai anaesthesia in patients with off-pump coronary artery bypass

作　　者：华震[1] 尹燕伟[1] 王爱娟[1] 王明山[1] 于文刚[1] 宋建防[1] 

机构地区：[1]青岛大学医学院附属医院麻醉科,山东青岛市266003

出　　处：《心血管康复医学杂志》2003年第6期514-516,共3页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:观察高胸段硬膜外阻滞对冠心病行非停跳冠状动脉旁路移植术(OPCABG)患者血浆内皮素(ET)及心钠素(ANP)浓度的影响。方法:2O例拟行OPCABG患者根据麻醉方法随机分为两组:A组为气管内插管全麻组;B组为高胸段硬膜外阻滞复合气管内插管全麻组。采用放免法测定术前,术终,术后24h、48h血浆ET及ANP浓度,记录血流动力学参数及所用血管活性药剂量。结果:B组术后,术后 24h、48h ET及 ANP值显著低于A组(P<0.01,P<0.05),血流动力学稳定,所用血管活性药物较少(P<0.05)。结论:高胸段硬膜外阻滞能抑制麻醉手术所致的应激反应,对OPCABG病人的心脏有保护作用。To investigate the heart protection of high thoracic epidural anaesthesia in patients with off-pump coronary artery bypass grafting (OPCABG). Methods: Twenty patients with coronary artery disease aged 38-72 years, undergoing OPCABG were enrolled in the study. The 20 patients were randomly equally divided into two groups according the methods of anaesthesia: In group A patients received general anesthesia, in group B patients received general anesthesia combined high thoracic epidural anesthesia (TEA). Artery blood samples were obtained before operation (T1), at the end of operation (T2). 24h (T3) and 48h (T4) after operation for deterct plasma endothelin (ET) and atrial natriuretic polypeptide (ANP). Results: Plasma ET and ANP levels in group B were significantly lower than those in group A after operation 24h (T3) (P<0.01) and 48h (T4) (P<0.05). The hemodynamics of group B in surgery was more stability than group A (P<0. 05). The drug applied for regulating blood vessel in group B was less (P<0. 05) also. Conclusion: In patients with OPCAB, TEA can effectively suppress the increase of plasma ET and ANP levels.

关 键 词：硬膜外阻滞麻醉 心钠素 内皮素 冠状动脉旁路移植术 0PCABG 血流动力学 

分 类 号：R654[医药卫生—外科学]