李繁;黎仕焕;韦雪梅;黄奕第;

• 1:海南医学院第二附属医院麻醉科
• 2:海南医学院第一附属医院解剖教研室

摘要(Abstract)：

目的:探讨围术期应用艾司洛尔对行胃癌根治术的老年冠心病患者的心肌保护作用。方法:选取2016年9月至2018年12月海南医学院第二附属医院收治的拟行胃癌根治术的老年冠心病患者122例,按照随机数字表法分为观察组和对照组,每组61例。观察组患者围术期给予艾司洛尔治疗,对照组患者给予0.9%氯化钠注射液。观察两组患者的左心功能指标[左心室射血分数(LVEF)、心排血量(CO)和心脏指数(CI)]、血清心肌肌钙蛋白Ⅰ(cTnⅠ)、肌酸激酶同工酶(CK-MB)水平及心脏不良反应事件发生情况,比较两组患者麻醉诱导前(T_0)、气管插管后(T_1)、气腹建立后(T_2)、手术结束时(T_3)、拔管时(T_4)及拔管后30 min(T_5)的平均动脉压(MAP)、心率(HR)及心率收缩压乘积(RPP)的差异。结果:术后24 h,两组患者LVEF、CO和CI水平明显高于麻醉诱导前,且观察组患者明显高于对照组,差异均有统计学意义(P<0.05)。T_1、T_2和T_4时,观察组患者HR水平明显低于对照组;T_1、T_2、T_3和T_4时,观察组患者MAP、RPP水平明显低于对照组,差异均有统计学意义(P<0.05)。术后6、12及24 h,观察组患者血清cTnⅠ和CK-MB水平明显低于对照组,差异均有统计学意义(P<0.05)。围术期及术后,观察组患者心绞痛、心律失常、心肌梗死及心肌缺血的发生率明显低于对照组,差异均有统计学意义(P<0.05)。结论:艾司洛尔应用于老年冠心病患者胃癌根治术围术期,可有效改善左心功能,稳定血流动力学,下调血清cTnⅠ和CK-MB水平,保护患者心肌功能,安全有效。

关键词(KeyWords)： 艾司洛尔;冠心病;胃癌根治术;围术期;心肌保护

Abstract:

Keywords:

基金项目(Foundation): 海南省自然科学基金(No.818QN319)

作者(Authors): 李繁;黎仕焕;韦雪梅;黄奕第;

DOI: 10.14009/j.issn.1672-2124.2019.07.011

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