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时间:2020-05-02
《全麻复合上胸段硬膜外阻滞对OPCAB患者循环及血浆NT-proBNP的影响.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、·440·江苏医药2012年2月第38卷第4期Jian~suMedJ,February2012,V0I38,No.4●论著●全麻复合上胸段硬膜外阻滞对OPCAB患者循环及血浆NT—proBNP的影响王曙吉林钱静于广东蔡国森【摘要】目的探讨上胸段硬膜外阻滞(TEB)对非心肺转流冠脉搭桥(0PCAB)患者血液动力学及血浆N末端原脑利钠肽(NT-proBNP)浓度的影响。方法2O例拟行OPCAB患者随机均分为两组:A组单用全麻,B组用全麻复合TEB。分别于麻醉诱导前(1'0)、术后lh(T1)、24h(T2)和48h(T3)测定血清肌钙蛋白I(cTnI)、心肌肌酸激酶
2、同工酶(CK-MB)和血浆NT-proBNP浓度;并记录血液动力学参数。结果与TO比较,A组于T1-3时点HR和MAP升高(P3、piduralblockadeonplasmaNT-proBNPandhemodynamiesinpatientsundergoingof-pmnpcoronaryartertybypassgraftingWc4ⅣGShu,JlLin,QIANJing,etaf.DepartmentofAnesthesiology,irdPeople'sHospitalofYancheng,Yancheng224001,CHINA[Abstract]ObjectiveToinvestigatetheeffectsofhighthoracicepiduralblockade(TE4、B)onplasmaN-terminal-pro-brain-natriuretiepeptide(NT-proBNP)andhemodynamicsinpatientsundergoingoff-pumpcoronaryarterybypassgrafting(0PCAB).MethodsTwentypatientsundergoing0PCABwereequallyrandomizedinto2groupsA(generalanesthesiaalone)andB(genera1anesthesiaplusTEB).Venousbloodsampleswer5、etakenbeforeinduction(:TO),at1h(T1),24h(T2)and48h(T3)afteroperationforthedeterminationsofplasmaconcentrationsofcalcitonin-I(cTnI),creatinekinase-musclebrainisozyme(CK_MB),andNproBNP.Hemodynamicparameterswererecordedatthesametimes.ResultsComparedwiththoseatTHRandMAPweresignificanthigh6、eratT1一T3ingroupA(P7、rainnatrlureticpeptide;CoronaryarterybypassgraftingIJiangsuMedJ,February2012,38(4):440.442.1上胸段硬膜外阻滞(TEB)通过阻断交感神经节资料与方法一一前纤维可控制心动过速,降低心肌梗死率,减弱心肌、般资料顿抑,改善左心室功能,促进心肌特别是缺血性心肌择期行OPCAB患者2O例,年龄58—76岁,体的氧供需平衡[1,2],因而在围麻醉期心肌保护领域重55—82kg,心功能Ⅱ一Ⅲ级。排除情况:严重肝肾得到应用。本研究观察TEB对非心肺转流冠状动疾患,严重心律失常,凝血功能障碍8、,严重脊柱畸形,脉搭桥术
3、piduralblockadeonplasmaNT-proBNPandhemodynamiesinpatientsundergoingof-pmnpcoronaryartertybypassgraftingWc4ⅣGShu,JlLin,QIANJing,etaf.DepartmentofAnesthesiology,irdPeople'sHospitalofYancheng,Yancheng224001,CHINA[Abstract]ObjectiveToinvestigatetheeffectsofhighthoracicepiduralblockade(TE
4、B)onplasmaN-terminal-pro-brain-natriuretiepeptide(NT-proBNP)andhemodynamicsinpatientsundergoingoff-pumpcoronaryarterybypassgrafting(0PCAB).MethodsTwentypatientsundergoing0PCABwereequallyrandomizedinto2groupsA(generalanesthesiaalone)andB(genera1anesthesiaplusTEB).Venousbloodsampleswer
5、etakenbeforeinduction(:TO),at1h(T1),24h(T2)and48h(T3)afteroperationforthedeterminationsofplasmaconcentrationsofcalcitonin-I(cTnI),creatinekinase-musclebrainisozyme(CK_MB),andNproBNP.Hemodynamicparameterswererecordedatthesametimes.ResultsComparedwiththoseatTHRandMAPweresignificanthigh
6、eratT1一T3ingroupA(P7、rainnatrlureticpeptide;CoronaryarterybypassgraftingIJiangsuMedJ,February2012,38(4):440.442.1上胸段硬膜外阻滞(TEB)通过阻断交感神经节资料与方法一一前纤维可控制心动过速,降低心肌梗死率,减弱心肌、般资料顿抑,改善左心室功能,促进心肌特别是缺血性心肌择期行OPCAB患者2O例,年龄58—76岁,体的氧供需平衡[1,2],因而在围麻醉期心肌保护领域重55—82kg,心功能Ⅱ一Ⅲ级。排除情况:严重肝肾得到应用。本研究观察TEB对非心肺转流冠状动疾患,严重心律失常,凝血功能障碍8、,严重脊柱畸形,脉搭桥术
7、rainnatrlureticpeptide;CoronaryarterybypassgraftingIJiangsuMedJ,February2012,38(4):440.442.1上胸段硬膜外阻滞(TEB)通过阻断交感神经节资料与方法一一前纤维可控制心动过速,降低心肌梗死率,减弱心肌、般资料顿抑,改善左心室功能,促进心肌特别是缺血性心肌择期行OPCAB患者2O例,年龄58—76岁,体的氧供需平衡[1,2],因而在围麻醉期心肌保护领域重55—82kg,心功能Ⅱ一Ⅲ级。排除情况:严重肝肾得到应用。本研究观察TEB对非心肺转流冠状动疾患,严重心律失常,凝血功能障碍
8、,严重脊柱畸形,脉搭桥术
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