摘要
目的为了观察高位硬膜外阻滞（ＴＥＡ）对不稳定型心绞痛的作用及血浆儿茶酚胺、血管紧张素Ⅱ的变化。方法４６例经临床确诊的不稳定型心绞痛病人随机分为２组，治疗组（ｎ＝２３）接受ＴＥＡ治疗，同时停用其它抗心肌缺血的药物，仅静点肝素，以防心肌梗死。对照组（ｎ＝２３）给常规治疗，但不给ＡＣＥＩ及ＡｇⅡ受体拮抗剂，分别观察疗效，并在治疗前、３天、７天时两组分别检测血浆儿茶酚胺、血管紧张素Ⅱ的变化。结果治疗后，ＴＥＡ组心绞痛缓解率１００％，心电图ＳＴ段压低导联和ＳＴ段压低值显著减轻，同时，ＴＥＡ组血浆肾上腺素、去甲肾上腺素、血管紧张素Ⅱ水平平行下降，而且比对照组下降有显著差异。结论ＴＥＡ作为不稳定型心绞痛的主要治疗手段，不但能显著止痛和改善心肌缺血状态，而且血浆儿茶酚胺、血管紧张素Ⅱ的值也显著下降。
Objective To investigate the role of thoracic epidural anesthesia(TEA) on patients with unstable angina pertoris.Methods Cases allocated as one of two groups.The TEA group(n=23) accepted TEA as the main therapy while infusing heparin only and stopped other anti-ischemia medicine.The controlled group(n=23)were treated in regular way except ACEI and ATl receptor blockade.Record the clinical effect and the plasma of noradrenalin/adrenaline and AgⅡ respectively before,during the 3rd and 7th day of TEA therapy.Results The rate of patients′ chest-pain relief is 100%after TEA.The sites of ST depression and total ST depression of 12 sites of ECG decreased significantly compared with previous accepting TEA therapy.Meanwhile,in the TEA group,the plasma of noradrenalin/adrenaline and AgⅡ decreased significantly compared with the controlled group. Conclusion The patients with unstable angina pectris accepted the TEA as main therapy can get both effective chest-pain relief and improve anti-ischemia condition. What is more,the plasma of noradrenalin/adrenaline and AgⅡ decreased significantly. [
出处
《中国急救医学》
CAS
CSCD
北大核心
1999年第3期146-148,共3页
Chinese Journal of Critical Care Medicine
关键词
高位硬膜外阻滞
不稳定型
心绞痛
儿茶酚胺
Thoracic epidural anesthesia Unstable angina pectoris Noradrenalin/adrenaline AngiotensinⅡ Outcome
