胸椎硬膜外阻滞治疗不稳定型心绞痛

TREATMENT OF UNSTABLE ANGINA PECTORIS THROUGH THORACIC EPIDURAL ANESTHESIA

目的 观察胸椎硬膜外阻滞 (TEA)治疗不稳定型心绞痛 (UAP)的疗效。方法 72例UAP患者随机分为TEA组及单纯药物治疗组 (对照组 )。TEA组应用英国佳士比 930 0PCA(患者自控镇痛泵 )于胸椎硬膜外注入 0 .0 62 5 %丁哌卡因 (布吡卡因 )与1 0 μg/kg吗啡混合液 ,以 4ml/h速度注入 ,连续 7～ 1 0d。 结果 TEA组治疗心绞痛起效快 ,总有效率 1 0 0 % (P <0 .0 1 ) ,且能减少心绞痛发作频率、缩短发作持续时间 ;心电图改善总有效率 91 .7% (P <0 .0 1 ) ;硝酸甘油停减率 1 0 0 %。结论 TEA治疗UAP疗效显著、方便。

Objective To observe the effectiveness of thoracic epidural anesthesia (TEA) for the treatment of unstable angina pectoris (UPA).Methods 72 UAP patients were randomly divided into two groups: TEA group and control group with pure drug therapy. 0.0625% of bupivacaine mixed into 10ug/kg of morphine was injected into TEA group at speed of 4ml/h for about 7~10 days through 9300PCA..Results UAP patients in TEA group responded to the treatment with much more effect, and the effective rate was 100% (P<0.01), and the UAP frequency and its lasting time were also reduced accordingly. The total improvement shown in the electrocardiogram was 91.7% (P<0.01). Nitroglycerinum was stopped or reduced (100%).Conclusion TEA is a safe, effective and convenient method for the treatment of UAP.