摘要
目的 观察术后硬膜外镇痛对老年患者血小板膜糖蛋白的影响 ,探讨其对部分血小板功能的作用。方法 98例择期手术的老年患者 ,随机分为镇痛组 (E组 )和对照组 (C组 ) ,每组 4 9例 ,镇痛组采用全麻联合硬膜外麻醉 +术后持续硬膜外输注镇痛 ,对照组采用复合全麻 +术后间断肌注哌替啶镇痛。分别于麻醉前、手术结束 1h和术后 2 4h抽取肘静脉血 ,采用流式细胞术双色免疫荧光染色测定血小板表面CD4 1/CD6 1、CD6 2P、CD6 3的表达量 ,同时测定血浆皮质醇和血糖水平 ,监测记录血压和心率。术后采用视觉模拟评分 (VAS)法评定镇痛效果。结果 对照组术后CD6 2P、CD6 3、CD4 1/CD6 1明显增高 ,与术前比较有显著性差异 (P <0 0 5 ) ,与镇痛组比较差异也有显著性意义 (P <0 0 5 )。结论 术后硬膜外持续输注镇痛安全可靠 ,可有效地抑制机体应激反应 ,阻滞交感神经兴奋 ,缓解血小板活化 ,是改善老年患者术后高凝状态的有效方法之一。
Objective To assess the effect of postoperative epidural analgesia on the expression of platelet membrane glycoproteinss(CD62P CD63 and CD41/CD61) in elder patients Methods 98 ASAⅡ Ⅲ elder patients aged from 60 to 80 years old undergoing elective operation were randomly divided into epidural analgesia group (group E , n= 49) and control group (group C , n= 49) The patients with blood disease or exposed to any medication with known platelet effects were excluded The patients in group E received postoperative continuous epidural analgesia, and the patients in group C received postoperative intramuscular phethatine anlgesia Blood samples were taken from peripheral vein before induction of anesthesia and after operation for the assessment of CD62P,CD63 and CD41/CD61 on the platelet membrane surface by flow cytometry ACT was determined at the same times HR and BP were monitored simultaneously Results In group C, the expressions of CD62P,CD63 and CD41/CD61 on the platelet membrane surface were significantly increased and HR,BP changed significantly too Conclusion Postoperative continuous epidural analgesia can inhibit the steess responses and the activity of platelet function availability and an efficacious measure for improving the hypercoagulable status of elder patients after operation
出处
《临床麻醉学杂志》
CAS
CSCD
2003年第5期282-283,共2页
Journal of Clinical Anesthesiology
