摘要
目的研究单纯全身麻醉与硬膜外麻醉复合全身麻醉对老年腹部手术患者心肌损伤的影响。方法临床纳入86例我院2014年8月~2017年8月行腹部手术的老年患者作为研究对象,根据麻醉方式不同分为两组,各43例。其中43例患者术中采用单纯全身麻醉作为对照组,另43例患者术中采用硬膜外麻醉复合全身麻醉作为观察组。观察两组患者心肌功能、血流动力学情况以及不良反应等。结果T0时两组患者CK-MB和cTnI水平比较,差异无统计学意义(P>0.05);T1~T3时观察组CK-MB和cTnI水平明显低于对照组(P<0.05)。麻醉前、手术结束时两组患者HR和MAP水平差异无统计学意义(P>0.05);切皮时、术中30min时观察组HR和MAP水平明显低于对照组(P<0.05)。两组患者不良反应包括肺部感染和躁动。观察组、对照组发生率分别为9.30%、6.98%,两组差异无统计学意义(P>0.05)。结论硬膜外麻醉复合全身麻醉在老年腹部手术患者中应用较好,血流动力学稳定,心肌功能影响小,安全性高,值得临床应用及推广。
Objective To study the effect of general anesthesia alone and epidural anesthesia combined with general anesthesia on the myocardial injury in elderly patients undergoing abdominal operations. Methods Eighty?six elderly patients who underwent the abdominal operations in our hospital from August 2014 to August 2017 were selected as research objects. They were divided into two groups according to the different anesthesia methods, with 43 cases in each group. 43 patients who underwent general anesthesia alone during the operations were set as the control group. 43 patients who underwent epidural anesthesia combined with general anesthesia during the operations were set as the observation group. The myocardial function, hemodynamic index and adverse reactions were observed. Results At T0, there were no significant difference in the values of CK-MB (creatine kinase-MB) and cTnI (cardiac troponin I) between two groups, P > 0.05. From T1 to T3, the values of CK-MB and cTnI in the observation group were significantly lower than those in the control group, P < 0.05. Before anesthesia and after operation, there were no significant difference in the HR (heart rate) and MAP (mean arterial pressure) levels between two groups, P > 0.05. HR and MAP levels in the observation group were significantly lower than those in the control group at the time of skin resection and at the time of 30min intraoperative, P < 0.05. Adverse reactions in both groups included pulmonary infection and agitation. The incidence of adverse reactions in the observation group and the control group were 9.30% and 6.98% respectively, and there was no difference between the two groups, P > 0.05. Conclusion Epidural anesthesia combined with general anesthesia is better used in elderly patients undergoing abdominal operations, with stable hemodynamics, little effect on myocardial function and high safety, which is worthy of clinical application and promotion.
作者
向鹏云
李子云
XIANG Pengyun;LI Ziyun(Department of Anesthesiology,the Western Hospital of South China Sea of China National Offshore Oil Corporation,Zhanjiang 524057,China)
出处
《中国医药科学》
2019年第13期135-137,254,共4页
China Medicine And Pharmacy
关键词
硬膜外麻醉
全身麻醉
腹部手术
心肌功能
Epidural anesthesia
General anesthesia
Abdominal operation
Myocardial function
