摘要
目的观察七氟醚与丙泊酚麻醉对老年冠心病非心脏手术患者的心肌保护作用及不良事件。方法选择2015-01~2016-01该院收治的行非心脏手术的老年冠心病患者86例,以随机数字表法分为观察组和对照组,每组43例,术中观察组给予七氟醚维持麻醉,对照组给予丙泊酚维持麻醉。通过检测两组血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、心肌肌钙蛋白(c Tn I)及糖原磷酸化酶BB(GP-BB)水平评估其心肌保护作用,比较两组不良事件包括常规不良事件与心脏不良事件发生情况。结果两组术毕即刻较麻醉前IL-6、TNF-α、c Tn I、GP-BB水平均显著升高(P<0.01),观察组IL-6、TNF-α、c Tn I、GP-BB水平依次为(204.68±94.20)pg/ml、(0.69±0.11)ng/ml、(0.82±0.19)ng/ml、(5.18±1.32)ng/ml,升高幅度均明显较对照组小(P<0.05);观察组常规不良事件发生率为6.98%,明显低于对照组的23.26%(P<0.05),心脏不良事件发生率为18.60%,明显低于对照组的44.19%(P<0.05)。结论七氟醚对老年冠心病非心脏手术患者心肌的保护效果优于丙泊酚,且可明显减少常规不良事件与心脏不良事件的发生。
Objective To observe the myocardial protective effect of sevoflurane and propofol anesthesia on the myocardium of elderly patients with coronary heart disease during noncardiac surgery and the adverse events.Methods Eighty-six elderly patients with coronary heart disease receiving noncardiac surgery in our hospital from January 2015 to January 2016 were selected,and divided into the observation group（n = 43） and the control group（n =43） by random number table.The observation group was given the maintenance anesthesia of sevoflurane during the operation,and the control group received the maintenance anesthesia of propofol.The serum levels of interleukin-6（IL-6）,tumor necrosis factor-α（TNF-α）,cardiac troponin（c Tn I） and glycogen phosphorylase BB（GP-BB） were detected to evaluate the myocardial protective effect and adverse events including conventional adverse events and adverse cardiac events and were compared between the two groups.Results The levels of IL-6,TNF-α,c Tn I and GPBB were significantly increased immediately after the surgery in the two groups than those before the anesthesia（P〈0.01）.The levels of IL-6,TNF-α,c Tn I and GP-BB in the observation group were（204.68 ± 94.20） pg/ml,（0.69 ±0.11） ng/ml,（0.82 ± 0.19） ng/ml and（5.18 ± 1.32） ng/ml respectively,and the ascending ranges of the observation group were significantly less than those of the control group（P〈0.05）; The incidence of the conventional adverse events in the observation group（6.98%） was significantly lower than that in the control group（23.26%）（P〈0.05）.The incidence of adverse cardiac events of the observation group（18.60%） was significantly lower than that of the control group（44.19%）（P〈0.05）.Conclusion Sevoflurane has better myocardial protective effect than propofol on the myocardium of the elderly patients with coronary heart disease during noncardiac surgery.
出处
《中国临床新医学》
2017年第4期344-347,共4页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
关键词
七氟醚
冠心病
非心脏手术
心肌保护
不良事件
Sevoflurane
Coronary heart disease
Noncardiac surgery
Myocardial protection
Adverse events
