文档介绍：硬膜外镇痛对冠心病患者手术后应激反应和心电图的影响
作者:陈国忠孙淑清李学周阿兴周松花张锐
【关键词】,镇痛
关键词: 镇痛;冠状动脉疾病;心电图;应激反应
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[(±)vs(±),P<];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<);③术后10和24h 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<). 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.
Keywords:electrocardiogram;stress response;coronary artery disease;analgesia
Abstract:AIM pare 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 pa
tients with coronary heart Pa-tients were followed up at6,10,24h after operation and the degree of pain,the change of ECG,the levels of cortisol,in-sulin and blood sugar were ①Efficacy of pain relief in EP group was superior to that in MI group [(±)vs(±),P<];②Levels of cortisol,insulin,blood sugar in MI group were markedly higher than those in EP group(P<).③At postopera-tive10h and24h the sites of ST depression and total ST de-pression of12sites of ECG in MI group significantly in-creased pared with preoperative values and those of EP group(P<).CONCLUSION Postoperative epidural analgesia can markedly reduce t