临床外科杂志 ›› 2018, Vol. 26 ›› Issue (11): 871-873.doi: 10.3969/j.issn.10056483.2018.11.023

• 论著 • 上一篇    下一篇

七氟烷吸入麻醉对开胸手术病人术后血清cTnI及心肌酶水平的影响作用探讨

  

  1. 723001  陕西省汉中市中医医院麻醉科(石奎);西安交通大学医学院附属3201医院麻醉科(贾洪峰)
  • 收稿日期:2018-03-27 出版日期:2018-11-20 发布日期:2018-12-03
  • 通讯作者: 贾洪峰,Email:Jiahongfeng3201@126.com

The effects of sevoflurane inhalation anesthesia on postoperative serum cTnI and myocardial enzyme levels in patients undergoing thoracotomy

  1.  Department of Anesthesiology,Hanzhong Hospital of Traditional Chinese Medicine,Shaanxi Province,Hanzhong 723001, China
  • Received:2018-03-27 Online:2018-11-20 Published:2018-12-03

摘要:   目的  分析七氟烷吸入麻醉对开胸手术病人术后血清cTnI及心肌酶水平的影响。方法开胸手术的病人62例,将病人随机分为观察组(30例)和对照组(32例),其中观察组手术中使用七氟烷全程吸入麻醉,对照组采用丙泊酚全凭静脉麻醉。记录并比较两组病人麻醉诱导前、体外循环(CPB)开始后10分钟(T1)、主动脉开放即刻(T2)、主动脉开放后30分钟(T3)、主动脉开放后1小时(T4)、CPB停机后6小时(T5)、CPB停机后24小时(T6)7个时间点心肌肌钙蛋白I(cTnI)水平及心肌酶水平。结果  两组病人7个时间点的cTnI浓度均呈递增趋势,且观察组在T4和T5时间点的浓度高于对照组;观察组T3时间点肌酸激酶同工酶及乳酸脱氢酶水平均低于对照组,差异均有统计学意义(P<0.05)。结论  吸入麻醉病人cTnI浓度普遍低于静脉麻醉病人,吸入性麻醉对心肌损害相对更轻,值得临床推荐。  

关键词: 吸入性麻醉,  ,  , 开胸手术,  , cTnI,  , 心肌酶

Abstract:    Objective    To investigate the effect of sevoflurane inhalation anesthesia on postoperative serum cTnI and myocardial enzyme levels in patients undergoing thoracotomy.Methods  62 cases of patients undergoing thoracotomy were selected for this study.The patients were randomly divided into the observation group and the control group.In the observation group,the patients were treated with sevoflurane inhalation anesthesia.In the control group,patients received propofol intravenous anesthesia.The Cardiac troponin I(cTn I)levels and myocardial enzyme levels at 7 time points of before induction of anesthesia,10 minutes after the start of CPB(T1),aortic opening immediately(T2),30 minutes after the opening of the aorta(T3),1 hour after the opening of the aorta(T4),and 6 hours after CPB shutdown(T5)and 24 hours after CPB shutdown were recorded and compared between the two groups of patients.Results  The cTnI concentrations of the two groups of patients showed an increasing trend at seven time points.The cTnI concentration of the observation group at the time points of T4 and T5 was higher than those of the control group.The levels of CKMB and LDH of the observation group at the time point of T3 were lower than those of the control group,and the difference was statistically significant(P<0.05).Conclusion  The cTnI concentration of inhaled anesthesia patients is generally lower than that of intravenous anesthesia patients.Compared with intravenous anesthesia patients,the recovery time of inhalation anesthesia patients is short,and the postoperative pain perception is relatively lower and the myocardial damage is relatively lighter,which is worthy of clinical recommendation.

Key words: inhalation anesthesia,  ,  , thoracotomy,  ,  , cTnI,  , myocardial enzymes

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