硬膜外镇痛对术后心肌缺血的影响

目的探讨硬膜外镇痛对术后心肌缺血的影响.方法将50例ASAⅡ-Ⅲ级择期食管癌切除患者,随机分为术后硬膜外镇痛组(A组,n=25)和对照组(C组,n=25).用Datex-Ohmeda S/5多导联自动ST段分析仪检测术后ST段变化情况,求得2组患者术后心肌缺血发生率及严重程度.结果A组术后镇痛效果明显优于对照组差异有统计学意义(t=3.60,P＜0.05);A组心肌缺血发生率(24%)低于C组(52%)差异有统计学意义(x2=4.16,P＜0.05);A组缺血负荷小于C组(3.4±4.8 vs 5.9±7.1)差异无统计学意义(t=0.85,P＞0.05);2组平均ST段变化无统计学意义.结论持续硬膜外镇痛能降低术后心肌缺血发生率,但不能明显改善其缺血程度.

Effects of Epidural Analgesia on Postoperative Myocardial Ischemia

Objective To explore the effects of epidural analgesia on postoperative myocardial ischemia.Methods Fifty postoperative patients with esophageal carcinoma were followed up.Twenty-five patients received epidural analgesia(A group).The myocardial ischemia was detected by Datex-Ohmeda S/5 monitor immediately after surgery and lasted for 24 hours.Incidence of postoperative myocardial ischemia and the change of ST segments were assessed.Results The efficacy of pain relief in A group was superior to that in C group(P<0.05);Incidence of postoperative myocardial ischemia in A group was 24% and in B group was 52%.(P<0.05);There was no significant between the two groups in the change of ST segments.Conclusion The way of epidural analgesia can effectively reduce the incidence of postoperative myocardial ischemia in.