【摘要】 目的:对比观察外周神经阻滞麻醉与传统腰-硬联合麻醉对高血压病患者下肢术后应激反应的影响。方法:选取广东省妇幼保健院行下肢手术的高血压病患者135例,以随机数字表法分为外周神经阻滞麻醉组(观察组,68例)和腰-硬联合麻醉(对照组,67例)。比较2组患者心率、血压及血清去甲肾上腺素、肾上腺素、血浆皮质醇水平,麻醉起效、神经阻滞时间,术后不良反应发生情况。结果:从术中10 min开始,观察组患者的血压、心率均明显优于对照组,差异均有统计学意义(P<0.05);术中及术后,2组患者血清去甲肾上腺素、肾上腺素、血浆皮质醇水平的差异无统计学意义(P>0.05);观察组患者麻醉起效迅速、作用时间长、术后并发症少。结论:外周神经阻滞麻醉既能维持患者血流动力学的稳定,又能减少术后应激反应及并发症,值得临床推广。更多还原

【Abstract】 OBJECTIVE: To observe the effect of peripheral nerve block anesthesia versus traditional combined spinal epidural anesthesia on the stress response of patients with hypertension following undergoing lower limb operation.METHODS: A total of 135 hypertensive patients undergoing lower limb operation in Guangdong Provincial Maternity and Child Healthcare Hospital were randomized to peripheral nerve block anesthesia group( observation group,n = 68) and combined spinal-epidural anesthesia group( control group,n = 67). The heart rate,blood pressure and serum levels of norepinephrine and adrenaline and plasma cortisol level were compared between the 2 groups. RESULTS: At 10 min of operation,the observation group was significantly better than the control group in blood pressure and heart rate,and the differences were statistically significant( P < 0. 05); serum levels of norepinephrine and epinephrine and plasma cortisol level during and after operation were of no statistically significant differences between the two groups( P > 0. 05); the observation group showed rapid onset and long duration of action of anesthetic effect yet few postoperative complications.CONCLUSIONS: The peripheral nerve block anesthesia can maintain the stability of the patient’s hemodynamics meanwhile reducing the postoperative stress reaction and complications,hence it is worthy of clinical promotion.更多还原