硬膜外阻滞下上腹部手术病人围手术期 血浆ACTH 皮质醇 醛固酮的变化

Perioperative Changes of ACTH、Cortisol and Aldosterone in Plasma during Selected Upper Abdominal Operations under Epidural Anesthesia

对１５例择期上腹部手术患者在硬膜外阻滞下围手术期血浆ＡＣＴＨ、皮质醇、醛固酮的变化进行了观察，结果表明在麻醉前后三种激素值无显著差异，在手术６０ｍｉｎ时均明显升高，与麻醉前值相比较有显著性差异，术毕６０ｍｉｎ时ＡＣＴＨ和皮质醇值仍有显著性差异。本研究表明在硬膜外阻滞下上腹部手术中有较活跃的应激反应存在，而腺垂体－肾上腺皮质轴直接参与了调节上腹部手术应激反应的作用。

The perioperative changes of ACTH、cortisol and aldosterone in plasma were observated in 15 patients undergoing selected upper abdominal operations under epidural anesthesia .The results were outlined as follows.There was no obvious change in levels of ACTH.cortosol and aldosterone in plasma after anesthesia .At 60 minutes after operational begining the levels of those hormones were markedly increased as compared with preoperative values.At 60 minutes atter operation levels of ACTH and cortisol were also different from preoperative values.This investigation showes that the stress responses were activated during upper abdominal operation under epidural anesthesia and that the stress responses during upper abdominal operation were directly regulated by the gland hypophsis suprarenal cortex axis.