【摘要】 【目的】研究阻滞右侧星状神经节对冠心病患者腹腔镜胆囊切除围术期的心肌肌钙蛋白Ⅰ(CT nI)的影响。【方法】选择20例 ASAⅡ~Ⅲ级冠心病行电视腹腔镜胆囊切除手术患者,随机分成对照组(A组)和试验组(B两组),每组各10人。B组于麻醉前行星状神经节阻滞。观察并监测两组术前(T0),麻醉前(T1),气管插管后1 min(T2),气管插管后5 min(T3)的平均动脉压(MAP)及心率(HR),心电图(ECG)的变化;在术前(T0),手术后4 h(T4)采静脉血3 ml测定CTnI含量进行比较。【结果】两组麻醉后 MAP均下降,差异有显著性(P<0.05)。HR两组虽有变化,但无统计学意义(P>0.05)。ECG:A组术前 5 例 S T段下移,术后有9例下移;B组术前6例,术后有7例S T段下移。CTnI:A组T4 升高,与T0 差异有显著性(P<0.05);B组T4 虽升高与 T0 差异无显著性(P > 0. 05); B 组与 A 组相比 T4 差异有显著性(P < 0. 05)。【结论】右侧星状神经节阻滞对冠心病腹腔镜胆囊切除手术患者具有心肌保护作用。更多还原

【Abstract】 To protect myocardia through regulation of sympathetic nerve function by right stellate ganglion block.Twenty patients, ASA gradeⅡ-Ⅲ ,with coronary heart disease undergoing laparoscopic cholecystectomy were selected and divided randomly into group A(control) and group B(test),10 cases in each. Stellate ganglion block was done in Group B before anesthesia.Mean artery pressure (MAP) and heart rate (HR) were measured respectively at preoperation(T 0) .preanesthesia(T 1),and 1 minute after intubation(T 2),5 minutes after intubation(T 3); Cardiac troponin (CTnI) of venous blood was measured preoperatively(T 0) and 4 hours after operation(T 4) respectively.MAP lowered after anesthesia in both groups with a significant difference (P<0.05). but there was no significant difference between both groups .HR changed without statistic significance (P>0.05).Postoperative S-T changes compared with preoperation showwed significant difference.CTnI in groups A increased at T 4 compared with T 0 showwed obvious difference(P<0.05).In group B,CTnI increased at T 4, compared with T 0 showwed no obvious difference(P>0.05). CTnI changed at T 4 with significant difference between two groups (P<0.05).[Conclusion]Right stellate ganglion block can protect myocardia of the patients with coronary heart disease during laparoscopic cholecystectomy.更多还原