摘要
[目的]观察PTCA术后患者行下肢手术,采用外周神经阻滞麻醉,血液动力学变化和心肌缺血情况及其临床意义。[方法]32例PTCA术后拟行下肢手术患者,施行腰丛联合坐骨神经阻滞麻醉,观察麻醉前即刻、切皮时、术中30min和术毕即刻收缩压(SP)、舒张压(DP)、心率(HR)变化,监测术前日24h、术中2～5h、术后48h动态心电图心肌缺血变化。[结果]切皮时、术中30min和术毕即刻的SP、DP、HR,较麻醉前即刻降低,差异显著有统计学意义;术中及术后平均每小时心肌缺血发作次数较术前明显增多,差异显著。[结论]外周神经阻滞麻醉对血液动力学影响小,可有效减少心血管不良事件的发生。
[Purpose]To study the changes of hemodynamic response and the states of myocardial ischemia with peripheral nerve block in patients with coronary heart disease after introcoronary stent（ICS）undergoing lower-extremity surgery in order to guide the clinical application.[Methods]Peripheral nerve block was performed on 32 patients with coronary heart disease after ICS undergoing lower-extremity surgery,the SP,DP and HR were measured before anesthesia,at the beginning of incision,30 min after the incision of surgery and after completion of operation;the states of myocardial ischemia reflected by DCG were monitored before 24h of surgery,2～5h after the incision and 48h after completion of operation.[Results]The SP,DP and HR were decreased more significantly at the beginning of incision,30 min after the incision of surgery and after completion of operation than before anesthesia（P〈0.05）.There were no significant differences of ST maximum displacement（STm）and duration of myocardial ischemia between after the incision of surgery and after completion of operation（P〈0.05）.The frequency of occurences of myocardial ischemia during and after the surgery was increased significantly（P〈0.05）.[Conclusion]Peripheral nerve block is a good choice for patients with coronary heart disease after ICS undergoing lower-extremity surgery,which exerts a little influence for hemodynamic response and myocardial ischemia.
出处
《浙江中医药大学学报》
CAS
2010年第2期176-177,共2页
Journal of Zhejiang Chinese Medical University
关键词
外周神经阻滞
冠状动脉支架
下肢手术
心肌缺血
peripheral nerve block
introcoronary stent
lower-extremity surgery
myocardial ischemia
