全麻复合硬膜外阻滞对老年高血压患者开胸手术应激反应的影响

Effects of Stress Response in Senile Hypertension Patients undergoing Thoracic Surgery by General Anesthesia with Epidural Block

目的：比较不同麻醉方法对老年高血压患者开胸手术应激反应的影响。方法：60例择期开胸手术的老年高血压患者,随机分为全麻组（A组）和全麻复合硬膜外阻滞组（B组）,监测两组患者的血流动力学变化,分别于麻醉前、插管后、术中及拔管时测定血浆肾上腺素、皮质醇及血糖浓度。结果：A组出现明显的心血管反应,B组血流动力学稳定,组间比较有统计学差异（P〈0.05~0.01）;B组内分泌各测定值无显著变化,A组则显著增高组间比较有统计学差异（P〈0.05~0.01）。结论：全麻复合硬膜外阻滞能减轻老年高血压患者开胸手术应激反应。

Objective：To compare the effect of different anesthetic techniques on the stress response of senile hy pertension patients undergoing thoracic surgery. Methods ：Sixty cases were randomly assigned to he operated upon general anesthesia （group A） and combined with general and thoracic epidural anesthesia （group B）. The hemodynamic changes were recored perioperatively,and epinephrine ,cortisol ,blood glucose were measured before anesthesia,after intubation,during operation and soon after extubation. Resuits：The singnificant cardiovascular reaction was observed in group A,in group B,BP and HR were more stable during perioperation compared with group A（P〈0.05-0.01）. The endocrine criteria measurements were not markedly changed in group B and significantly elevated in group A. Conclusion：General anesthesia combined with epidural block can reduce the stress respones of senile hypertension patients undergoing thoracic surgery.