【摘要】 目的观察左侧星状神经节阻滞(SGB)对冠心病患者全麻冠状动脉旁路移植术(CABG)中血流动力学的影响。方法将38例全麻下行CABG患者随机分为观察组和对照组各19例,观察组麻醉前采用1%利多卡因行SGB,对照组注射10 ml生理盐水行SGB。观察两组SGB前(T0)、SGB后10 min(T1)、麻醉诱导插管即刻(T2)、切皮(T3)及劈胸骨时(T4)的平均动脉压(MAP)、右室每搏功指数(RVSWI)、中心静脉压(CVP)、心排血量(CO)、心脏指数(CI)、心率(HR)、外周血管阻力(SVR)、肺血管阻力(PVR)、左室每搏功指数(LVSWI)指标。结果观察组T2时点MAP及T1、T2时点RVSWI均明显低于T0时点;T2、T3时点MAP,T1时点CVP、CO、CI,T1时点RVSWI均明显低于对照组,P均<0.05。两组HR、SVR、PVR、LVSWI比较无统计学差异。结论冠心病患者行SGB短时间内可增加CO,改善心功能,并可缓解麻醉插管或手术强刺激引起的循环波动。更多还原

【Abstract】 Objective To investigate the effects of left stellate ganglion block(SGB) on the hemodynamics in patients undergoing coronary artery bypass grafting(CABG) with general anesthesia.Methods Thirty-eight patients undergoing CABG were randomly divided into observed group and control group with 19 in each,SGB was operated with 1%lidocaine 10 ml in observed group and saline 10 ml in control group.Cardiac output(CO),heart rate(HR),mean arterial blood pressure(MAP),central venous pressure(CVP),PAP,PCWP were recorded before SGB(T0),10 mins after SGB(T1),time of intubation(T2),incision(T3) and sternotomy(T4),while the(SV),cardiac index(CI),systemic vascular resistance(SVR),pulmonary vascular resistance(PVR),left ventricular-stroke work index(LVSWI)and right ventricular-stroke work index(RVSWI)were calculated.Results MAP at T2 and RVSWI at T1,T2 were all significantly lower than those at T0 in the observed group;the MAP at T2,T3 and CVP,CO,CI,RVSWI at T1 were all significantly lower than those in the control group,P<0.05.No significant difference was found in the HR,SVR,LVSWI between the two groups.Conclusions SGB can increase CO and improve cardiac function in patients with coronary heart disease,and also can decrease the fluctuation of circulation stimulated by intubation or operation.更多还原