摘要
目的 观察冠心病患者上腹部手术后硬膜外镇痛(Epidural,EP)对机体应激反应及心电图的影响 .方法 比较术后 EP与肌注哌替啶 (MI)的镇痛效果 ,检测围术期患者血清皮质醇、胰岛素、血糖和心电图的变化情况 .结果 1镇痛效果 :EP组优于 MI组 [(1.5 6± 0 .5 3) vs (4 .2 2± 1.74) ,P<0 .0 1];2术后血清皮质醇、胰岛素和血糖浓度 :EP患者明显低于 MI患者 (P<0 .0 5 ) ;3术后 10和 2 4h ST段压低导联数和 ST段压低值总和 :EP组趋于减少 ,MI组则明显多于术前水平和 EP组 (P<0 .0 5 ) .结论 冠心病患者上腹部手术后硬膜外镇痛明显减轻术后疼痛应激反应并减少心肌缺血的发生 .
AIM To compare the effects of postoperative epidural single bolus bupivacaine analgesia (EP group) with intramuscular injection (MI group) of pethidine after upper abdominal operation on stress response and electrocardiogram in patients with coronary heart disease. METHODS Patients were followed up at 6, 10, 24 h after operation and the degree of pain, the change of ECG, the levels of cortisol, in sulin and blood sugar were assessed. RESULTS ① Efficacy of pain relief in EP group was superior to that in MI group [(1.56±0.53) vs (4.22±1.74), P <0.01]; ② Levels of cortisol, insulin, blood sugar in MI group were markedly higher than those in EP group ( P <0.05). ③ At postoperative 10 h and 24 h the sites of ST depression and total ST depression of 12 sites of ECG in MI group significantly increased as compared with preoperative values and those of EP group ( P <0.05). CONCLUSION Postoperative epidural analgesia can markedly reduce the stress response and improve myocardial ischemia in patients with coronary heart disease undergoing upper abdominal operation.
出处
《第四军医大学学报》
北大核心
2001年第5期442-444,共3页
Journal of the Fourth Military Medical University
