摘要
目的观察老年人围术期心率变异性（HRV）的变化，探讨硬膜外术后镇痛对自主神经系统的影响。方法随机选择48例择期行下腹部、会阴区手术的患者，按年龄分为两组：老年组（L组，65～80岁），年轻组（N组，30～64岁），监测并记录患者入室后（T0）、切皮前（T1）、术后1d（T2），2d（T3），3d（T4）的BP，HR和HRV的变化，并记录术后疼痛评分及肛门排气时间。结果术后两组HRV各指标普遍比基础值降低，且均在T2时间点降至最低（P〈0．01）。两组间比较，心率变异指数（HRVI），LF，HF，TP在T1至T4时间点L组低于N组（P〈0．05）。LF／HF在T2，T3时间点L组低于N组（P〈0．05）。结论HRV监测分析可较好地评估围术期机体自主神经变化；硬膜外术后镇痛对老年人自主神经系统调节影响程度大于年轻人。
Objective To observe the changes of peri-operative heart rate variability（ HRV ） in the elderly, and estimate the effect of postoperative epidural analgesia on autonomic nervous system. Methods Forty-eight patients undergoing elective lower abdominal and perineal surgery were randomly assigned into two groups：the elderly group（L, 65 -80y） and the younger group（ N,30 -64y）. Blood pressure（BP） ,heart rate（ HR） ,and HRV after going into surgery room（ T0） ,before skin incision（T1） ,and 1,2,3d after surgery were monitored and recorded. We also recorded the pain score after operation and the time of anal exhaustion. Results All the components of HRV in both groups after operation are lower than their basic values, and decreased to lowest at T2（P 〈 0.01）. HRVI, LF, HF, TP at T1 and T4 in L group are lower significantly than N group（ P 〈0.05）. And LF/HF at T2 and T3 in L group is also lower significantly than N group （ P 〈 0.05 ）. Conclusion Monitoring and analyzing HRV can well estimate the changes of peri-operative autonomic nervous of individuals;the effect of postoperative epidural analgesia on the elderly＇s autonomic nervous system is larger than the younger.
出处
《潍坊医学院学报》
2008年第3期248-250,共3页
Acta Academiae Medicinae Weifang
关键词
硬膜外术后镇痛
吗啡
自主神经
老年人
Postoperative epidural analgesia
Morphine
Autonomic nervous
The elderly
作者简介
逢淑萍（1977年～），女（汉族），山东省胶州市人，主治医师，在读硕士研究生。主要研究方向：麻醉学。
[通讯作者]艾登彬，主任医师，硕士研究生导师。主要研究方向：临床麻醉学。
