不同麻醉对老年冠心病患者实施非心脏手术术后的影响

目的 研究并分析不同麻醉方法对于老年冠心病患者实施非心脏手术术后的影响.方法 本院择2014年5月至2015年4月期间老年冠心病实施非心脏手术患者共138例,随机分为A组和B组,A组患者行连续硬膜外麻醉,B组患者行右美托咪定-芬太尼-维库溴铵全身麻醉诱导与维持,观察两组患者的术后影响.结果 A组患者相比于B组患者,手术前后心率和舒张压无明显变化,结果比较不具有显著性差异（P〉0.05）,收缩压明显降低,结果比较具有显著性差异（P〈0.05）;术后高血压、心律失常以及心绞痛等心脏不良反应发生率明显增加,两组结果比较具有显著性差异（P〈0.05）;术后恶心、呕吐、认知障碍等常规不良反应发生率明显增加,两组结果比较具有显著性差异（P〈0.05）.结论 连续硬膜外麻醉对于老年冠心病患者实施非心脏手术术后影响较小,安全可行,值得推广.

Objective to research and analyze the different anesthesia method for aged patients with coronary heart disease （CHD） the influenceof non cardiac surgery. Methods we choose during May 2014 to April 2015, A total of 138 patients with senile coronary heart disease （CHD） toimplement the heart surgery, were randomly divided into group A and group B, group A patients with continuous epidural anesthesia, group B patientsright beauty microphones set - fentanyl - d ku bromide general anesthesia induction and maintenance, to observe postoperative effects of two groups ofpatients. Results compared with patients in group B patients of group A, heart rate and diastolic pressure has no obvious change before and afteroperation, the result is not A significant difference （P 〉 0.05）, significantly lower systolic blood pressure, compared with the results significant difference（P 〈 0.05）; Postoperative hypertension, arrhythmia, and angina heart significantly increased incidence of adverse reactions, two sets of results comparedwith significant difference （P 〈 0.05）; Postoperative nausea and vomiting, cognitive impairment and other conventional significantly increased incidenceof adverse reactions, two sets of results compared with significant difference （P 〈 0.05）. Conclusion continuous epidural anesthesia for aged patientswith coronary heart disease （CHD） non cardiac surgery is affected, safe and feasible, is worth promoting.