【摘要】 目的分析超声引导下交感神经阻滞对心绞痛患者麻醉效果、麻醉药物用量、麻醉阻滞起效时间、麻醉维持时间,血流动力学指标(血液比粘度、红细胞压积、红细胞沉降率及纤维蛋白原)及心肌酶谱肌钙蛋白I、肌酸激酶同工酶、乳酸脱氢酶的影响。方法选择2015年10月至2017年1月收治的120例难治性心绞痛患者,其中研究组60例,对照组60例,对照组采用盲探下交感神经阻滞,研究组采用超声引导下交感神经阻滞,分别于盲探或超声引导下于治疗位点单次注入0.375%罗哌卡因15 ml。评价2组患者麻醉效果;记录麻醉药物用量、麻醉阻滞起效时间、麻醉维持时间,并检测治疗前后对血流动力学指标影响。结果研究组麻醉总有效率为96.67%明显高于对照组75.00%,2组之间差异有统计学意义(P<0.05);2组患者麻醉药物用量、麻醉阻滞起效时间及麻醉维持时间对比,观察组患者的麻醉药物用量、麻醉阻滞起效时间均优于对照组,麻醉维持时间较对照组长,差异有统计学意义(P<0.05);全血粘度高切粘度、全血粘度低切粘度、纤维蛋白原、血浆粘度等血流动力学指标和c Tn I、LDH、CK-MB等心肌酶谱指标均优于对照组,2组之间差异有统计学意义(P<0.05)。结论超声引导下交感神经阻滞麻醉的效果显著,可减少麻醉药物用量,缩短麻醉阻滞起效时间,延长麻醉维持时间,其血流动力学及心肌酶谱指标均有显著改善,值得临床广泛应用。更多还原

【Abstract】 Objective To investigate the influences of ultrasound guided sympathectic nerve block on the anesthetic effects,anesthetic dosage,onset time of anesthesia blocking,anesthesia maintenance time,haemodynamics indexes including blood specific viscosity,hematocrit,erythrocyte sedimentation rate and fibrinogen,myocardial zymogram indexes including cardiac troponin I( c Tn I),creatine kinase isoenzyme( CK MB) and lactate dehydrogenase( LDH) in patients with angina pectoris. Methods A total of 120 patients who were diagnosed as refractory angina pectoris in our hospital from October 2015 to January 2017 were randomly divided into research group( n = 60) and control group( n = 60). The patients in control group were treated by sympathetic nerve block under blind searching,however,the patients in research group were treated by ultrasound guided sympathectic nerve block,moreover,the patients in both groups were given a single injection of 0. 375%ropivacaine 15 ml at treatment site under blind searching or under ultrasound guidance,respectively. The anesthetic effects,anaesthetic drugs dose,onset time of anesthesia blocking and anesthesia maintenance time as well as the changes of hemodynamic indexes before and after treatment were observed and compared between two groups. Results The total effective rate in research group was 96. 67%,which was significantly higher than that( 75%) in control group( P < 0. 05). The anaesthetic drugs dose,onset time of anesthesia blocking and anesthesia maintenance in research group were superior to those in control group( P < 0. 05). Moreover the haemodynamics indexes including high shear viscosity and low shear viscosity of whole blood,fibrinogen,plasma viscosity and myocardial zymogram indexes including c Tn I,LDH,CK MB in research group were superior to those in control group( P < 0. 05). Conclusion The ultrasound guided sympathetic nerve block anesthesia has significant effects,which can significantly reduce the anesthetics drugs dose,shorten the onset time of anesthesia blocking,prolong the duration of anesthesia,which ca nalso significantly improve the hemodynamics and myocardial zymogram indexes,therefor,which is worth using widely in clinical practice.更多还原