摘要
目的：对比研究单纯全麻与硬膜外加全麻对全髋置换术患者的血液流变学的影响。方法：１６例ＡＳＡⅠ～Ⅱ级，行择期全髋置换术患者随机分为两组。Ⅰ组为全麻组，Ⅱ组为硬膜外加全麻组，诱导前硬膜外给２％利多卡因５ｍｌ，有平面后行全麻诱导，全麻用药与Ⅰ组相同，术中用利多卡因硬膜外阻滞，每５０ｍｉｎ给药６～８ｍｌ，术后２４ｈ内用０５％布比卡因镇痛，Ⅰ组术后肌注哌替啶镇痛。结果：两组血液流变学的主要差异：Ⅱ组的血液还原粘度、血浆粘度及纤维蛋白原浓度术中明显下降，术后恢复接近术前。Ⅰ组这三项指标术中也明显下降，但术后３天内均反跳明显高于术前。结论：硬膜外阻滞能更好地抑制应激反应，其对血流变学的影响更有利于预防术后下肢静脉炎和静脉血栓的形成。
Objective:The study was undertaken to compare the effects of general anaesthesia and epidural block plus general anaesthesia on haemorheology. Methods:Sixteen adult patients, ASA grade Ⅰ～Ⅱ, scheduled for elective total hip replacement were divided randomly into two groups. Group Ⅱ( n=8 ),5ml,2% lidocaine was given epidurally before induction of anaesthesia, and every 50min 6～8ml was added after induction. The group Ⅰ was not given epidural anesthisisa, and the general anaesthesia method of both groups was similar in induction and maintenance. In 24 houurs after operation, 0 5% bupivacaine was given epidurally in group Ⅱ and pethidineim.in group Ⅰ for pain relief. Results:The blood reducing viscocity, plasma viscocity and concentration of fibrinogen were decreased markedly during operation in two groups. These index recovered to the level of preoperation on the third postoperative day in group Ⅱ, but were higher than that in group Ⅰ. Conclusion: As compared with the general anaesthesia, epidural anaesthesia may attenuate the endocrine responses to stress more effectively and improve haemorheology, which is helpful in preventing deep venous thrombosis postoperatively.
出处
《临床麻醉学杂志》
CAS
CSCD
1999年第1期11-13,共3页
Journal of Clinical Anesthesiology
关键词
血液流变学
全髋置换术
麻醉方法
General anaesthesia Epidural anaesthsia Haemorehology
