硬膜外阻滞对老年病人左室功能影响的超声心动图观察

Effects of Epidual Block on Left Ventricle Function In Elderly Patients: Assesed with Ultrasoniccardiogram

本文采用超声心动图观察老年病人硬膜外阻滞前后左室功能的变化,并同中青年病人对比。阻滞平面达T_5以上的老年组,MAP下降显著(P<0.05),SV的增加最少,CO、CI值呈下降趋势,而其余各组均增加10％以上。T_5以上两组的EF、△D％与mVCF下降值均大于T_7以下两组,T_5以上两组的EPSSb均增加显著(P<0.05),而T_7以下中青年组并无变化,表明硬膜外阻滞对心功能的影响与阻滞平面的高低有明显关系;T_5以上阻滞时,心功能抑制较明显,老年病人尤为突出;T_7以下阻滞,则抑制轻微,提示心交感神经阻滞是心功能抑制的关键因素,老年人应避免高平面的硬膜外阻滞。

Changes of the function of the left ventricle after epidual block in aged patients were studied by ultrasonic- cardiogram and compared with that in the middle-aged and young. When the block level was over T_5 in the elderly patients, MAP decreased markedly (P<0. 05) with slight increase of SV, CO and CI tended to decrease but they increased by more than 10% in other groups. Declining value of EF. △D% and MVCF was higher in the two groups over T_5 than in the two groups below T_7 EPSSb in both goups over T_5 increased significantly, while no changes occurred in groups below T_7 It is suggested that the effects of the epidual block on the function of the left ventricle are obviously related to the height of block level. As it is over T_5, the heart function is marked inhibited, especially in elderly patients. When the level is below T_7, the inhibition is slight. It is concluded that block in the cardio-sympathetic nerve is the key cause of the inhibition in ventriclar function, high-level epidual block is not indi- cated in elderly patients.