| 摘要: |
| 目的观察七氟烷和地氟烷吸入麻醉对非体外循环冠脉搭桥术（OPCABG）患者血流动力学和应激反应的影响。方法选择接受全身麻醉下OPCABG患者60例,年龄5174岁,BMI 2030kg/m2,ASA分级III级,随机分为七氟烷组（S组,n=30）和地氟烷组（D组,n=30）。两组常规静脉麻醉诱导后插入气管导管,S组患者调节七氟烷浓度为11.5 MAC;D组调节地氟烷浓度为11.5 MAC。在不同时间点:手术开始前（T0）、吻合血管前（T1）、吻合血管后（T2）、手术结束时（T3）和术后24小时（T4）记录血流动力学指标,并抽取血液标本进行皮质醇、胰岛素、肌酸激酶同功酶（CK-MB）和C反应蛋白（CRP）水平的检测。结果D组患者术中血压、心率与T0相比显著增加,差异有统计学意义（P<0.05）。两组患者皮质醇、胰岛素、CK-MB和CRP与T0相比显著增加,差异有统计学意义（P<0.05）,但D组增加更为明显;组间比较,与D组相比S组患者:平均动脉压和心率在T1和T2显著降低,皮质醇和CK-MB水平在T1T4显著降低,差异有统计学意义（P<0.05）,胰岛素和CRP水平差异无统计学意义（P>0.05）。结论七氟烷比地氟烷吸入麻醉在OPCABG患者能更好地控制血流动力学的变化和应激反应。 |
| 关键词: 七氟烷 地氟烷 非体外循环冠状动脉移植 血流动力学 应激 |
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| Effects of Sevoflurane and Desflurane on Hemodynamics and Stress Reaction in Patients with Off-pump Coronary Artery Bypass Grafting |
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Wang Han;Wu Zhichao;Bao Xiaohang1,2
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1.Department of Anesthesiology in Nanchong Central Hospital;2.Department of Anesthesiology,Xinqiao Hospital,Third Military Medical University
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| Abstract: |
| Objective To observe the effects of sevoflurane and desflurane inhalation anesthesia on hemodynamics and stress reaction in patients with off-pump coronary artery bypass grafting（OPCABG）.MethodsA total of 60 patients with OP-CABG undergoing general anesthesia,age 5174 years,BMI 20 to 30kg/m2,ASA grade III grade,were randomly divided into sevoflurane group（S group,n=30）and desflurane group（D group,n=30）.Two groups of patients were inserted into tracheal tube after routine intravenous anesthesia induction.The concentration of sevoflurane in group S was 1 to 1.5 MAC,and the concentration of desflurane in group D was 1 to 1.5 MAC.Hemodynamic index was recorded and blood samples were collected for cortisol,insulin,creatine kinase isoenzyme（CK-MB）and C reaction protein（CRP）were detection at different time points:before the start of surgery（T0）,before vascular anastomosis（T1）,after vascular anastomosis（T2）,at the end of operation（T3）and 24 hours after operation（T4）.Results The blood pressure and heart rate in operation of the patients in the D group were significantly increased compared with the T0,and the difference was statistically significant（P<0.05）.The level of cortisol,insulin,CK-MB and CRP of the patients in the two groups were significantly increased compared with the T0,and the difference was statistically significant（P<0.05）,but the D group was more obvious;comparison between groups,compared with the D group,the mean arterial pressure and heart rate decreased significantly in the T1and T2,cortisol and CK-MB levels in T1T4were significantly decreased in the S group,the difference was statistically significant（P<0.05）,and there was no statistically significant differences in insulin and CRP levels（P>0.05）.ConclusionCompared with desflurane,sevoflurane inhaled anaesthesia can better control changes in hemodynamics and stress reaction in OPCABG patients |
| Key words: sevoflurane desflurane off-pumpcoronaryarterybypassgrafting hemodynamics stressreaction |
