冠心病心力衰竭病人胸段硬膜外阻滞后心功能变化

目的：观察冠心病心力衰竭（CHF）病人高位胸段硬膜外阻滞（HTEA）前后脂质过氧化物和左心室舒缩功能的变化,方法：选择48例冠心病心力衰竭病人均分为HTEA组（n=24)及常规治疗组（n=24),观察治疗前后心功能,丙二醛（MDA）,超氧化物歧化酶（SOD）的变化。结果：治疗后CHF病人心脏舒缩功能的改善;HTEA组明显优于常规治疗组（P＜0．05）,MDA含量HTEA组明显低于常规治疗组（P＜0．01）,SOD则明显高于常规治疗组（P＜0．05）,结论：HTEA治疗CHF病人对心脏舒缩功能的改善明显优于常规法,其增强抵抗自由基的能力是可能的机制之一。

Effect of thoracic epidural anesthesia on heart function in eldly patients with coronary heart disease

Objective To observe the effect of thoracic epidural anesthesia (HTEA) on lipid peroxidation substance,left ventricle systole and diastole function in patients with coronary heart disease companied by heart failure(CHF).Methods Forty-eight patients with CHF were randomly divided into HTEA group(n=24) and routine treatment group(RT group,n=24).The cardiac function was observed pre-and post-HTEA.The level of MDA and superoxide dismutase(SOD) were monitored and the changes of cardiac output(CO) and ejection fraction(EF)were detected by echocardiography.Results There was much more improvement of left ventricle systole function and diastole function in HTEA group than that in RT group after treatment(P<0.05).The level of MDA was significantly lower in HTEA group than that in RT group after treatment (P<0.01).But,the level of SOD in HTEA group was apparently higher than that in RT group after treatment(P<0.05).Conclusion HTEA is superior to routine treatment in treatment of coronary heart disease with heart failure,for which the increased ability of anti-free radical may be one of the mechanisms.