CAJ | 학술논문

目的观察蛛网膜下腔阻滞麻醉(腰麻)对老年患者围手术期血清肌钙蛋白T(TN-T)的影响,探讨其应用于冠心病患者的安全性.方法 40例老年患者依术前有无冠心病史分为两组,每组20例,Ⅰ组为有冠心病组,Ⅱ组为无冠心病组.两组患者均采用单次腰麻复合硬膜外联合麻醉,分别于麻醉前、手术结束时和术后24 h采集血样,应用罗氏电化学发光全自动免疫分析仪E170检测血清TN-T含量,观察患者有无冠心病发作症状及体征,记录患者的年龄、手术时间、麻醉平面、出血量,监测心电图、血压、心率、脉搏血氧饱和度.结果两组患者的年龄、手术时间、麻醉平面、出血量、输液量、血压、心率、脉搏血氧饱和度等差异无统计学意义,两组患者组内各时点血样TN-T差异无统计学意义,两组患者未发现冠心病发作症状体征.Ⅰ组与Ⅱ组各时点TN-T检验阳性率为5%、5%、20%,构成比差异无统计学意义.两组患者均有1例麻醉前TN-T＞0.010μg/L,手术过程及术后TN-T均高于参考值,患者无不适.结论腰麻对老年冠心病患者围手术期血清肌钙蛋白T无明显影响.
목적 관찰주망막하강조체마취(요마)대노년환자위수술기혈청기개단백T(TN-T)적영향,탐토기응용우관심병환자적안전성.방법 40례노년환자의술전유무관심병사분위량조,매조20례,Ⅰ조위유관심병조,Ⅱ조위무관심병조.량조환자균채용단차요마복합경막외연합마취,분별우마취전、수술결속시화술후24 h채집혈양,응용라씨전화학발광전자동면역분석의E170검측혈청TN-T함량,관찰환자유무관심병발작증상급체정,기록환자적년령、수술시간、마취평면、출혈량,감측심전도、혈압、심솔、맥박혈양포화도.결과 량조환자적년령、수술시간、마취평면、출혈량、수액량、혈압、심솔、맥박혈양포화도등차이무통계학의의,량조환자조내각시점혈양TN-T차이무통계학의의,량조환자미발현관심병발작증상체정.Ⅰ조여Ⅱ조각시점TN-T검험양성솔위5%、5%、20%,구성비차이무통계학의의.량조환자균유1례마취전TN-T＞0.010μg/L,수술과정급술후TN-T균고우삼고치,환자무불괄.결론 요마대노년관심병환자위수술기혈청기개단백T무명현영향.
Objective To explore the security of spinal anesthesia by observing the pefioperation serum troponin T in the elderly patients with coronary heart disease who underwent spinal anesthesia.Methods 40 case8 were divided into two groups according to the elderly patients with or without the history of coronary heart disease.Group Ⅰ 0f 20 cases were the patients with the history of coronary heart disease.Group Ⅱ of 20 cases were the patients without the history of coronary heart disease.Both groups were undertaken single spinal anesthesia combined with epidural anesthesia.The blood samples were collected at the time of perioperation,the end of the operation and 24 hours after surgery.The serum troponin T Was tested by Roche fully automated ehemiluminescent analyzer E170.The symptoms and signs of the coronary heart disease in the patient were observed.And the age,operation time,anesthesia lever,the amount of bleeding and transfusion were recorded,and at the same time,electrocardiogram,heart rate,pulse,cerebral oxygen saturation were monitored.Results There was no significant difference between two groups in age,operation time,anesthesia lever,the amount of bleeding and transfusion,heart rate,pulse,cerebral oxygen saturation.There was no significant difference between two groups in seram troponin T.No symptoms and signs of the coronary heart disease were observed in two groups.There Was no significant difference between two groups in constituent ratio of positive rate of serum troponin T.There was one case in each group that serum lroponin T was more than reference value (0.010μg/L)during the perioperation while the patient was no discomfort.Conclusion Spinal anesthesia has no impact on the change of perioperative 8ertlm troponin T in the elderly patients with coronary heart disease.