不同部位麻醉手术对肾素、血管紧张素、醛固酮和皮质醇的影响

Influence of Different Location Anesthesia and Surgery on Renin, Angiotensin, Aldosterone and Cortisol

应用放免分析法，分别对胸段连续硬膜外麻醉下行上腹部手术（A组，12例）和腰段连续硬膜外麻醉下行盆腔或下肢手术（B组，12例）围术期血浆肾素活性（PRA）、血管紧张素Ⅱ（AⅡ）醛固酮（ALD）和皮质醇（COR）监测，其结果显示：A组PRA、ALD和COR变化有显著意义（P＜0．05），而B组的变化无显著意义（P＞0．05）；同时通过对两组患者围术期血流动力学观察，显示A组血压和心率降低幅度小于B组，表明不同部位麻醉手术下机体应激反应程度有显著差别，这对进一步认识和掌握应激时机体的调节、保护和储备能力，提高围术期安全性有重要意义。

The changes of plasma renin activity (PRA), angiotensinll (AII), aldosterone (ALD)and cortisol(COR) were observed with radioimmuoassay during elective upper abdominal surgery under continuous thoracic epidural anesthesia (groupA, n=12)and elective basin cavity or lower extremity surgery under continuous lumbar epidural anesthesia(group B, n=12 ) The results showed that the changes of PRA, ALD and COR in group A were significant (P < 0. 05) and these chamges in group B were mild (P>0. 05 ). On the observation of blood flow dynamics, it was found that the reduction extent of BP and HR in group A was smaller than that in group B. The article pointed out that the extent of stress response of human body under different location anesthesia and surgery was obviously disparite.This will help us to deeply study and master the adjustment, protection and reserve capability of human body under stress condition and raise safety during operation.