七氟烷与丙泊酚对冠心病患者上腹部手术围麻醉期应激反应作用的比较

目的比较冠心病患者上腹部手术中七氟烷与丙泊酚对围麻醉期应激反应抑制的效果。方法选择择期行胃大部切除术的冠心病患者40例,随机分为七氟烷+瑞芬太尼(SR组,n=20)和丙泊酚+瑞芬太尼(PR组,n=20)组。记录术中血管活性药物使用情况。术前,术后即刻,术后6,12,24h抽取颈内静脉血测定C-反应蛋白(CRP),皮质醇和AtⅡ浓度。结果应激反应指标皮质醇,CRP,AtⅡ术前无明显差异,术后即刻,术后6,12,24h数据显示SR组低于PR组。结论七氟烷复合瑞芬太尼比丙泊酚复合瑞芬太尼麻醉对冠心病患者上腹部手术具有更好的应激反应抑制效果。

Sevoflurane and Propofol on upper abdominal surgery in patients with coronary heart disease around the role of stress response during anesthesia compared

Objective To compare Sevoflurane and Propofol for abdominal surgery on patients with coronary heart disease in the stress response dampening effect.Methods 40 patients with coronary heart disease,elective gastrectomy were randomly divided into Sevoflurane ＋ Remifentanil（SR group,n=20） and Propofol ＋ Remifentanil（PR group,n=20） groups.Observed the hemodynamic parameters and recorded theuse of vasoactive drugs during intraoperative.Determination of C-reactive protein serum（CRP）,cortisol,and At Ⅱ concentration.Results Hemodynamic differences in the two groups of patients was not significant.Stress response index Cortisol,CRP,At Ⅱ no significant difference in preoperative.Immediately after operation,after 6,12,24 h data were lower SR group than in PR group.Conclusion Sevoflurane Remifentanil than Propofol remifentanil anesthesia for upper abdominal surgery in patients with coronary heart disease has a better inhibitory effect of the stress response.