摘要
目的:研究不同麻醉方法与OPCAB围术期内皮素-1(ET-1)、血管紧张素Ⅱ(AngⅡ)的变化及其与临床多种有关指标的关系,以指导临床上选择合适的麻醉方法。方法:62例冠心病行OPCAB病人随机分为两组:A组,全身麻醉组;B组,全身麻醉复合高位硬膜外麻醉组。每组31例。观察每组病人术后一周内围术期心衰、围术期心梗、围术期心率失常、使用IABP、肺脏及其他重要脏器并发症的发生率,测定术前(T1)、术终(T2)、术后24h(T3)血浆ET-1、AngⅡ水平。结果:术后围术期心衰、心梗、心率失常、使用IABP、肺脏及其他重要脏器并发症的发生率B组较A组小,但差别无统计学意义(P>0.05);两组病人血浆内的ET-1和AngⅡ浓度在T2和T3时均明显较T1时间增高(P<0.05),但T2和T3之间的比较差别无显著性(P>0.05);同一时间点的组间比较:在T2时和T3时B组病人的血浆ET-1和AngⅡ浓度均明显较A组的低(P<0.05)。结论:全身麻醉复合高位硬膜外麻醉比单用全身麻醉方法更适用于OPCAB术中。
Objective: To investigate the effects of three anesthetic methods on level of Peptides Endothelin-1 ( ET-1 ) and Angeotensin Ⅱ ( Ang Ⅱ ) in patients undergoing off-pump coronary bypass grafting (OPCAB). Methods: 62 patients undergoing OPCAB were separated into two groups: patients in group A were anesthetized by general anesthesia and group B in combination of thoracic epidural anesthesia and general anesthesia. To all patients, the level of ET-1 and Ang Ⅱ of plasma before operation (T1), at the end of operation (T2) and 24h (T3) were detected and operating outcomes were observed. Result: There were no significantly differences in operating outcomes among two groups. In two groups, the level of ET-1 and Ang Ⅱ in T2 , T3 were higher than that in T1 Compared to group B. Conclusions: In patients undergoing OPCAB, combination of thoracic epidural anesthesia can more effectively suppress the increase of plasma ET-1 and Ang Ⅱ level than general anesthesia, providing better heart protection during operation.
出处
《河北医学》
CAS
2005年第12期1057-1059,共3页
Hebei Medicine