星状神经节阻滞稳定全麻气管内插管及切皮时应激反应的初步研究

首都医科大学学报 ›› 2000, Vol. 21 ›› Issue (2): 125-127.

星状神经节阻滞稳定全麻气管内插管及切皮时应激反应的初步研究

赵春亭¹, 王恩真¹, 张迎萍¹, 苗传龙¹, 王国苏², 吴静²

1. 首都医科大学附属北京天坛医院麻醉科;2. 首都医科大学附属北京天坛医院检验科

收稿日期:1999-09-20 修回日期:1900-01-01 出版日期:2000-04-15 发布日期:2000-04-15

Effect of Stellate Ganglionic Block on Endocrine Changes at Tracheal Intubation and Incision with General Anesthesia

Zhao Chunting¹, Wang Enzhen¹, Zhang Yingping¹, Miao Chuanlong¹, Wang Guosu², Wu Jing²

1. Dept. of Anesthesiology, Beijing Tiantan Hospital, Affiliate of Capital University of Medical Sciences;2. Dept. of Laboragorg, Beijing Tiantan Hospital, Affiliate of Capital

Received:1999-09-20 Revised:1900-01-01 Online:2000-04-15 Published:2000-04-15

摘要/Abstract

摘要： 为观察应用星状神经节阻滞(SGB)后全麻诱导气管内插管及手术切皮时内分泌的变化,将神经外科择期手术病人按麻醉方法的不同,分为阻滞组(S组,n=14,于麻醉诱导前5min行左SGB)与对照组(N组,n=14)进行对比观察。测量入室(t₀)、气管插管后1min(t₁)、手术开始切皮(t₂)3个时间的血浆皮质醇(COR)、催乳素(PRL)和胰岛素(INS)浓度以及收缩压(SBP)、舒张压(DBP)和心率(HR).结果：S组3个时间的COR及PRL呈下降趋势、INS呈上升趋势;N组3个时间的COR及PRL呈上升趋势、INS呈下降趋势;且SBP、HR、COR和PRL组内差比较均为N组>S组(P<0.05和P<0.01).显示SGB后诱导气管内插管及切皮时的SBP、HR及COR、PRL和INS变化相对较小。提示全麻诱导前行SGB具有抑制气管内插管及手术切皮时应激反应和稳定血流动力学的作用。

关键词: 星状神经节阻滞, 气管内插管, 内分泌变化, 应激反应

Abstract: To observe the effect of SGB on endocrine changes at tracheal inubation and incision with general anesthesia and to estimate the effect of cervical sympathetic block on regulating and controlling the stress response during this period of time.Twenty eight ASAⅠ～Ⅱ patients for selective neurosurgery were randomly divided into two groups: Group S contains patients who received left SGB five minutes before induction, while Group N as negetive controll is comprised of those who did not receive SGB.Blood specimens were taken to measure the concentration of plasma corticosteroids, prolactin and insulin before anesthesia induction(t 0), after tracheal indubation (t 1),and at the time of incision(t 2). The patients were induced with fentanyl, pancuroniun, and propofol before tracheal intubation.The results showed that concentrations of COR and PRL decreased while INS increased in group S; Concentrations of COR and PRL increased; while INS decreased in group N. Plama level of COR and PRL in group N significantly increased in comparison with group S(P<0.05, P<0.01). Conclusion: Changes of COR, PRL and INS were relatively smaller after SGB during tracheal intubation and incision with general anesthesia which suggest that SGB before induction effectively suppress the stress response during tracheal intubation and incision in general anesthesia work as stable blood dynamics.

Key words: stellate ganglionic block, tracheal intubation, endocrine changes, stress response

中图分类号:

R614.4

赵春亭;王恩真;张迎萍;苗传龙;王国苏;吴静. 星状神经节阻滞稳定全麻气管内插管及切皮时应激反应的初步研究[J]. 首都医科大学学报, 2000, 21(2): 125-127.

Zhao Chunting;Wang Enzhen;Zhang Yingping;Miao Chuanlong;Wang Guosu;Wu Jing. Effect of Stellate Ganglionic Block on Endocrine Changes at Tracheal Intubation and Incision with General Anesthesia[J]. Journal of Capital Medical University, 2000, 21(2): 125-127.

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