吸入性麻醉药对缺血性心脏病患者非心脏手术后血清中cTnI水平的影响

目的: 探讨吸入性麻醉药在缺血性心脏病患者非心脏手术中对心肌的保护作用.方法: 选取缺血性心脏病且需其他部位手术的患者96例,随机分为2组,各48例,其中对照组采用静脉麻醉的方式,治疗组采用吸入性麻醉的方式,比较吸入性麻醉药物和静脉麻醉药物对围手术期心脏事件和术后心肌缺血事件的影响,观察不同麻醉方式对患者血清肌钙蛋白Ⅰ水平的影响.结果: 治疗组患者术中低血压发生率31.25%,低氧血症6.25%,使用心血管活性药物37.50%;对照组术中低血压发生率43.75%,低氧血症14.58%,使用心血管活性药物64.58%,2组术中低血压和低氧血症发生率差异均无统计学意义(P >0.05),而治疗组患者心血管活性药物使用率明显低于对照组(P< 0.01);治疗组术后1、2、3 d 肌钙蛋白Ⅰ浓度异常情况发生率与对照组差异均无统计学意义(P >0.05);治疗组患者在术后即刻、术后第1天和第2天心肌缺血事件的发生率与对照组差异均无统计学意义(P >0.05).结论: 应用吸入性麻醉药物可以降低患者术中心血管药物使用,吸入性麻醉药物对冠状动脉硬化性心脏病患者接受中危非心脏手术时具有一定的心肌保护作用,可以作为老年冠心病患者的麻醉策略优化选择.

Effect of inhaled anesthesia on the serum level of cTnI in patients with ischemic heart disease after non-cardiac surgery

Objective: To explore the protective effects of the inhaled anesthesia on myocardium in non-cardiac surgery patients with ischemic heart disease.Methods: Ninety-six patients with ischemic heart disease treated with other operation were randomly divided into the control group and treatment group(48 cases each group),treatment group were treated with control and inhaled anesthesia,respectively.The effects of whose on the perioperative cardiac event,ischemic event and level of cTnI in patients were compared.Results: The incidence rates of intraoperative hypotension,hypoxemia and using cardiovascular active drugs in treatment group and control group were 31.25%,6.25% and 37.50%,and 43.75%,14.58% and 64.58%,respectively,hypotension and hypoxemia had no significant difference in the incidence rate of intraoperative(P< 0.05),but unilization of cardiovascular cative drugs treatment group was significantly lower than the control group(P< 0.01).The differences of the concentration anomalies of cTnI in treatment group and control group at postoperative 1,2 and 3 days were not statistically significant(P >0.05).The differences of the incidence rate of myocardial ischemic event in treatment group and control group after anesthesia and at postoperative 1,2 and 3 days were not statistically significant(P >0.05).Conclusions: The inhaled anesthesia can reduce the use of cardiovascular drugs,and protect the myocardium in non-cardiac surgery patients with ischemic heart disease,which can be used as the preferred treatment for elderly patients with coronary heart disease.