【摘要】 目的:比较单纯全麻和全麻复合胸段硬膜外阻滞(TEA)对冠心病患者非开胸手术围术期心肌保护作用的观察。方法:38例非开胸手术患者随机均分为两组。A组仅采用单纯全身麻醉,B组术中采用TEA复合全身麻醉,观察两组围术期平均动脉压、心率、ST-T段的变化及TnT的水平。结果:各个时间点A组患者的平均动脉压、心率明显高于基础值(P<0.05),B组各时点无差异(P>0.05);两组患者心肌缺血改善A组总有效率为31.5%,B组总有效率为84.2%;TnT含量在术后1h开始升高(P<0.05),24h明显升高(P<0.05),24h时B组TnT水平低于A组(P<0.05)。结论:胸段硬膜外阻滞复合全麻组患者的血流动力学稳定,心肌缺血、缺氧改善明显,有效地减轻了心肌损伤。更多还原

【Abstract】 Objective:To evaluate the effect of thoracospinal epidural anesthesia on perioperative myocardial protection effect in patients with coronary artery disease undergoing non cardiac surgical operation.Methods:38 examples open epigastric surgery patients were divided equally two groups stochastically.The group A only used the pure general anesthesia,in the group B technique used the TEA compound general anesthesia,observed two groups to encircle the technique time average arterial pressure,the heart rate,the ST-T section change and the TnT release level.Results:Each time selected A group of patient’s average arterial pressure,the heart rate to be higher than the foundation value obviously(P<0.05),Group B various points in time do not have the difference(P>0.05);two group of patient cardiac muscle ischemia improvement situation group A total effectiveness was 31.5%,group B total effectiveness was 84.2%;TnT content after the technique 1h started to elevate(P<0.05),24h incresse(P<0.05),after the technique,24h drop,the group B patient TnT level was lower than group A(P<0.05).Conclusion:Thoracospinal epidural anesthesia keep the patient’s blood dynamics stable with coronary artery disease,improve the cardiac ischemia and injury,shows the better myocardial protection effect.更多还原