老年肿瘤患者开胸围手术期血浆皮质醇与血管紧张素Ⅱ水平的探讨

Study on Levels of Plasma Cortisol and AngiotensionⅡ in Aged Patients with Tumor During Thoracic Operation

探讨老年肿瘤患者开胸手术期间应激相关指标血浆皮质醇（P-C）与血管紧张素Ⅱ（AngⅡ）水平的变化。应用RIA分别测定20例老年肿瘤患者在术前、切皮、术中1h、术毕、术后1天血浆P—C与AngⅡ的含量，按年龄分为A组40～49岁，B组50～59岁，C组60～69岁，D组70～79岁。老年肿瘤患者开胸手术期间血浆P—C与AngⅡ的水平与对照组相比，5个时间点无显著性差异（P〉0．05）；而D组术中1h、术后1天P—C显著升高，与C组相比有显著性差异（P〈0．05）。术后1天D组AngⅡ明显升高，与B、C组相比有显著性差异（P〈0．05）。手术期间各时间点P-C与AngⅡ无相关性。70岁以上老年人术后应激反应较其它年龄组强烈。术后应密切监测老年人血浆P—C与AngⅡ的水平，做好相应护理以防并发症的发生。

To explore change of indicators related to stress such as plasma cortisol （P-C） and angiotensin Ⅱ （Ang Ⅱ ） during thoracic operation in aged patients with tumor. The levels of P-C and Ang Ⅱ were measured at the time point of before operating, skin incision, operating for 1h, right after operation, 1d after operation with RIA in 20 cases of aged patients with tumor. Patients were divided into 4 groups according to ages. group A 40-49, group B 50-59, group C 60-69, group D 70-79. There were no significant differences （P〉0.05） in the levels of P-C and Ang Ⅱ in patients at the five time points during operation under general anesthesia as compared with control group. While level of P-C in group B increased significantly at the point of operating for 1h and one day after operation, comparing with that of group C（P〈0.05）. Ang Ⅱ in group D one day after operation also increased remarkably and had significant difference comparing with group B, C （P〈0.05）. There was no relativity between levels of P-C and Ang Ⅱ on five time points. The stress of operation in group D assumed to be more intensive than that in other groups. In order to prevent development of complications, the levels of P-C and Ang Ⅱ should be closely monitored, together with corresponding care.