硬膜外持续镇痛对食管癌手术患者血液流变学的影响

目的 :观察硬膜外术后镇痛患者的血液流变学变化 ,为减少术后并发症提供参考。方法 :将 2 8例患者随机分为观察组和对照组 ,2组患者均于麻醉前、手术结束时、术后 2 4h和 4 8h分别抽取外围静脉血进行血液流变学测定和比较。结果 :观察组术后 2 4h全血及血浆黏度、纤维蛋白原、红细胞压积和红细胞叠连指数始升高 ,4 8h近术前值。对照组 2 4h上述指标始升高 ,其中全血黏度、纤维蛋白原升高显著 ,且 4 8h时仍明显高于麻醉前 (P <0 0 5 )。观察组红细胞可塑性变形指数增加 ,至 4 8h仍高于术前 (P <0 0 5 ) ,对照组渐下降至术前水平。结论 :持续硬膜外术后镇痛 ,能够减少术后并发症 ,有利于术后患者的康复

Effect of Continuous Epidural Analgesia on Hemorheotogy after Operation of Carcinoma of the Esophagus

Objective To investigate the influence of continuous epidural analgesia on the hemorheotogy and supply reference was to reduce postoperative complications.Methods Twenty eight patients of carcinoma of the esophagus were studied.The patients were randomly divided into two groups:general anesthesia group (group C n =14) and continous epidural anesthesia group (group CEA n =14).Hemorheology parameters were monitored and recorded on before anesthesia,at the end of the surgery,twenty four and forty eight hours after surgery.Results In group CEA,the viscosity of blood and blood plasma,fibrinogen,hematocrit value,rouleaux formation of erythrocyte all began to increase on the 24th hour after operation and returned to the baseline on the 48th hour after operation.The plastic deformation of erythrocyte level increased significantly( P <0 05).In group C,the hemorheology parameters increased on the 24th hour after operation.And the viscosity of blood,fibrinogen levels increared significantly on the 24th and 48th hour after operation( P <0 05).The plastic deformation of erythrocyte level returned to the baseline on the 48th hour after operation.Conclusions The postoperative complications can be prevented effectively and the mortality be decreased markedly after operation by continuous epidural analgesia. China J Cancer Prev Treat,2003,10(3):309-311