CAJ | 학술논문

目的：探讨硬膜外阻滞复合异氟醚吸入全麻对血流动力学和肝血流的影响及其静脉输入3．5％尿素交连明胶(UG)的作用。方法：18只犬分两组，行胸段硬膜外阻滞后吸入0．5和1．0MAC异氟醚。实验组硬膜外阻滞前开始静脉输入UG12ml／kg。监测体循环、肺循环、肝动脉、门静脉血流动力学。肝血流用电磁血流仪测定。结果：对照组硬膜外阻滞后BP、HR、肝动脉阻力和门静脉血流均下降，加吸0．5MAC异氟醚使外周血管阻力(SVR)、肺动脉压和门静脉压降低；1．0MAC后心排血量下降、肝动脉血流也比0．5MAC时减少。心搏量(SV)于吸入异氟醚后有所升高。实验组硬膜外阻滞后HR减慢、SV增加而SVR下降,肝脏循环稳定。吸入异氟醚后全身和肝脏血流动力学变化显著轻于对照组。结论：硬膜外阻滞后，随异氟醚浓度升高，体循环、肺循环、肝动脉、门静脉血流动力学发生显著变化；胶体液扩容对此有明显的防治作用。
목적：탐토경막외조체복합이불미흡입전마대혈류동역학화간혈류적영향급기정맥수입3．5％뇨소교련명효(UG)적작용。방법：18지견분량조，행흉단경막외조체후흡입0．5화1．0MAC이불미。실험조경막외조체전개시정맥수입UG12ml／kg。감측체순배、폐순배、간동맥、문정맥혈류동역학。간혈류용전자혈류의측정。결과：대조조경막외조체후BP、HR、간동맥조력화문정맥혈류균하강，가흡0．5MAC이불미사외주혈관조력(SVR)、폐동맥압화문정맥압강저；1．0MAC후심배혈량하강、간동맥혈류야비0．5MAC시감소。심박량(SV)우흡입이불미후유소승고。실험조경막외조체후HR감만、SV증가이SVR하강,간장순배은정。흡입이불미후전신화간장혈류동역학변화현저경우대조조。결론：경막외조체후，수이불미농도승고，체순배、폐순배、간동맥、문정맥혈류동역학발생현저변화；효체액확용대차유명현적방치작용。
Objective: To explore whether colloid solution 3.5 % polygeline (UG) could change the effects of epidural block combined with isoflurane inhalation on systemic, pulmonary and hepatic hemodynamics. Methods: 18 healthy mongrel dogs anesthetized with epidural block combined with 0.5 or 1.0 MAC isoflurane inhalation were divided into 2 groups randomly, control group(groupⅠ)and UG group (groupⅡ). In group Ⅱ, UG of 12ml/kg was infused introvenously. Systemic,pulmonary and hepatic hemodynamics were studied. Blood flow of hepatic artery and portal vein was monitored continuously with electromagnetic flowrneter. Results: In group I, HR, MAP, hepatic artery resistance and portal vein blood flow decreased significantly after epidural block. Combined with 0.5MAC isoflurane, SVR, MPAP, PVP decreased and SV increased. With 1.0 MAC, CO decreased and hepatic artery blood flow was lower than that in 0.5 MAC. In group Ⅱ, after epidural block HR and SVR decreased and SV increased significantly. There was no significant change of hepatic hemodynamics. During isoflurane inhalation, changes of systemic, pulmonary and hepatic hemodynamics were significantly less important than those in group I. Conclusion: Epidural block combined with high concentration of isoflurane inhalation causes disturbance of systemic,pulmonary and hepatic hemodynamics. The disturbance can be prevented effectively by UG infusion.