七氟醚对老年冠心病患者胃癌根治术的心肌保护作用

The effect of sevoflurane on myocardial protection in aged patients with coronary heart disease undergoing abdominal surgery

目的比较老年冠心病患者胃癌根治术中七氟醚和丙泊酚麻醉的心肌保护作用。方法择期行胃癌根治手术患者40例,ASAⅡ或Ⅲ级,年龄65～85岁,随机均分为丙泊酚复合瑞芬太尼组(P组)和七氟醚复合瑞芬太尼组(S组)。记录术中血管活性药物使用情况。分别于术前、术后即刻、术后6、12、24h抽取中心静脉血测定血清心肌肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)浓度。结果两组血管活性药物使用情况差异无统计学意义。术后6、12、24hS组CK-MB、cTnI浓度明显低于P组(P<0.05)。结论七氟醚复合瑞芬太尼比丙泊酚复合瑞芬太尼麻醉对老年冠心病患者行胃癌根治术具有更好的心肌保护效果。

Objective To compare the effects of sevoflurane and propofol anesthesia on myocardial protection in aged patients with coronary heart disease undergoing abdominal surgery. Methods Forty patients, ASAⅡ or Ⅲ, aged 65-85, were selective underwent with radical operation for carcinoma of stomach under general anesthesia, they were randomly divided into two groups： propofol combined with remifentanil（group P） and sevoflurane combined with remifentanil（group S）, The drugs of vasoactive were recorded, the concentrations of CK-MB and cTnI were measured. Results There were no difference between two groups in vasoactive drugs; CK-MB, cIhI in group S were lower than that in group P at 6 h, 12 h, 24 h postoperatively（P〈0. 05）. Conclusion Sevoflurane combined with remifentanil would be better myocardial protection than propofol combined remifentanil anesthesia for aged coronary heart disease patients with radical operation for carcinoma of stomach.