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静脉快通道麻醉联合硬膜外阻滞对老年患者血浆ET及TXB_2的影响

, PP. 966-969

Keywords: 静脉,快通道麻醉,硬膜外,内皮素,血栓素,老年人

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Abstract:

目的观察静脉快通道联合硬膜外麻醉对老年患者上腹部手术围术期血浆内皮素(ET)及血栓素A2(TXA2)的影响。方法择期行胃癌根治术患者68例,ASAⅠ~Ⅱ级,随机分为单纯静脉快通道全麻组(A组)与静脉快通道联合硬膜外麻醉(B组)。分别于麻醉前(T0)、插管后5min(T1)、切皮后5min(T2)、进腹探查(T3)时和术毕拔管后(T4)在非输液侧各采集静脉血6mL。采用放射免疫法测定血浆ET、TXB2含量,同时观察血流动力学变化。结果两组患者麻醉效果均满意,总麻醉时间组间比较差异无统计学意义(P>0.05);患者从静脉停止给药至睁眼时间、术毕至离开手术室时间及拔管时间B组明显短于A组(P?0.01)。Steward评分术毕10minA组≥4分者(25例)少于B组≥4分者(34例),P0.05);B组T3、T4时间点SBP、MAP及HR显著低于A组同时间点(P0.05),两组间相同时间点比较差异也无统计学意义(P>0.05)。A、B组患者在T1、T2、T3时血浆TXB2水平均低于T0时(P<0.05);B组T2、T3、T4时血浆TXB2水平低于A组(P<0.05)。结论静脉快通道联合硬膜外麻醉对老年上腹部手术患者血浆TXB2调控优于静脉全麻,能有效减轻患者围手术期的应激反应,有利于患者术后康复。

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