中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2014年
8期
962-964
,共3页
麻醉,全身%二异丙酚%鼻息肉%外科手术%纤维蛋白溶解%七氟醚
痳醉,全身%二異丙酚%鼻息肉%外科手術%纖維蛋白溶解%七氟醚
마취,전신%이이병분%비식육%외과수술%섬유단백용해%칠불미
Anesthesia,general%Propofol%Nasal polyps%Surgical procedures,operative%Fibrinolysis%Sevoflurane
目的 比较不同麻醉下鼻息肉摘除术患者的纤溶功能.方法 择期行鼻息肉摘除术患者40例,ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为2组(n=20):异丙酚复合麻醉组(P组)和七氟醚复合麻醉组(S组).于麻醉诱导前(T1)、手术30 min(T2)和术毕(T3)时分别取静脉血样,采用放射免疫分析法测定血浆皮质醇、促肾上腺皮质激素(ACTH)浓度,采用乳胶凝集法测定D-二聚体(DD)浓度,采用酶联免疫吸附法检测组织型纤溶酶原激活物(t-PA)和纤溶酶原激活物抑制物(PAI-1)浓度.结果 与T1时相比,T2时两组血浆皮质醇及ACTH水平降低(P＜0.05),T3时差异无统计学意义(P＞0.05),组间比较差异无统计学意义(P＞0.05).与T1时相比,T2,3时两组血浆DD、t-PA和PAI-1水平明显升高(P＜0.05);与P组比较,S组T2,3时血浆DD、t-PA水平降低,血浆PAI-1水平升高(P＜0.05).结论 异丙酚复合麻醉下纤溶功能增强的程度高于七氟醚复合麻醉,其更适宜于鼻息肉摘除术.
目的 比較不同痳醉下鼻息肉摘除術患者的纖溶功能.方法 擇期行鼻息肉摘除術患者40例,ASA分級Ⅰ或Ⅱ級,採用隨機數字錶法分為2組(n=20):異丙酚複閤痳醉組(P組)和七氟醚複閤痳醉組(S組).于痳醉誘導前(T1)、手術30 min(T2)和術畢(T3)時分彆取靜脈血樣,採用放射免疫分析法測定血漿皮質醇、促腎上腺皮質激素(ACTH)濃度,採用乳膠凝集法測定D-二聚體(DD)濃度,採用酶聯免疫吸附法檢測組織型纖溶酶原激活物(t-PA)和纖溶酶原激活物抑製物(PAI-1)濃度.結果 與T1時相比,T2時兩組血漿皮質醇及ACTH水平降低(P＜0.05),T3時差異無統計學意義(P＞0.05),組間比較差異無統計學意義(P＞0.05).與T1時相比,T2,3時兩組血漿DD、t-PA和PAI-1水平明顯升高(P＜0.05);與P組比較,S組T2,3時血漿DD、t-PA水平降低,血漿PAI-1水平升高(P＜0.05).結論 異丙酚複閤痳醉下纖溶功能增彊的程度高于七氟醚複閤痳醉,其更適宜于鼻息肉摘除術.
목적 비교불동마취하비식육적제술환자적섬용공능.방법 택기행비식육적제술환자40례,ASA분급Ⅰ혹Ⅱ급,채용수궤수자표법분위2조(n=20):이병분복합마취조(P조)화칠불미복합마취조(S조).우마취유도전(T1)、수술30 min(T2)화술필(T3)시분별취정맥혈양,채용방사면역분석법측정혈장피질순、촉신상선피질격소(ACTH)농도,채용유효응집법측정D-이취체(DD)농도,채용매련면역흡부법검측조직형섬용매원격활물(t-PA)화섬용매원격활물억제물(PAI-1)농도.결과 여T1시상비,T2시량조혈장피질순급ACTH수평강저(P＜0.05),T3시차이무통계학의의(P＞0.05),조간비교차이무통계학의의(P＞0.05).여T1시상비,T2,3시량조혈장DD、t-PA화PAI-1수평명현승고(P＜0.05);여P조비교,S조T2,3시혈장DD、t-PA수평강저,혈장PAI-1수평승고(P＜0.05).결론 이병분복합마취하섬용공능증강적정도고우칠불미복합마취,기경괄의우비식육적제술.
Objective To compare the fibrinolysis in the patients undergoing nasal polypectomy under different methods of anesthesia.Methods Forty ASA physical status Ⅰ or Ⅱ patients,scheduled for elective nasal polypectomy,were randomized into 2 groups (n =20 each) using a random number table:propofol-based anesthesia group (group P) and sevoflurane-based anesthesia group (group S).Venous blood samples were taken before induction of anesthesia (T1),at 30 min after the beginning of operation (T2),and at the end of operation (T3) for determination of the levels of plasma cortisol,adrenocorticotropic hormone (ACTH),D-dimer (DD),tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor 1 (PAI-1).Results Compared with the baseline value at T1,the plasma cortisol and ACTH levels were significantly decreased at T2,and no significant change was found at T3 in the two groups,and there was no significant difference between the two groups.The plasma DD,t-PA and PAI-1 levels were significantly higher at T2,3 than at T1.Compared with group P,the plasma DD and t-PA levels were significantly decreased at T2,3,while the plasma PAI-1 level was increased at T2.3 in group S.Conclusion Propofol-based anesthesia provides higher degree of enhancement in fibrinolysis than sevoflurane-based anesthesia and it is more suitable for the patients undergoing nasal polypectomy.
