不同麻醉方法对胸部手术应激反应的影响

Effect of different anesthetic methods on stress response in chest operation

目的:观察不同麻醉方法对胸部手术患者应激激素的影响。方法:42例肺癌手术患者随机分为全麻复合硬膜外腔阻滞(GEA)组和全麻(GA)组,每组21例,分别测定麻醉诱导前、手术2h、术毕、术后1d的血浆去甲肾上腺素、肾上腺素、内皮素、C-反应蛋白、皮质醇的水平。结果:GEA组的血浆去甲肾上腺素、内皮素和血清皮质醇,术中、术后差异无显著性(P>0.05),与GA组比较差异有非常显著性(P<0.01)。两组血浆肾上腺素,术中、术后差异均无显著性(P>0.05)。两组血清C-反应蛋白,术中、术后均显著升高(P<0.01),组间比较差异无显著性。结论:硬膜外腔阻滞可以减轻胸部手术的应激反应。

Objective: To study the effect of different anesthetic methods on stress hormone in chest operation. Methods: Forty-two patients with pulmonary carcinoma were randomly divided into two even groups: general anesthesia (GA) group and general anesthesia plus epidural anesthesia (GEA) group. Plasma levels of norepinephrine, adrenaline, endothelin, C-reaction protein (CRP) and cortisol were detected before anesthesia induction, at 2 hours during operation, at the end of operation and on the 1st postoperative day, respectively. Results: The contents of norepinephrine, endothelin and cortisol in GEA group were markedly lower than those in GA group (P<0.01). CRP level in two groups was increased significantly during and after operation compared with before operation (P<0.01). There was no statistical difference in adrenaline concentration between pre- and post-operation in two groups (P>0.05). Conclusion: Stress response can be relieved by epidural anesthesia in patients undergoing thoracic operation.