星状神经节阻滞对非体外循环冠脉移植术病人ACTH、AT-Ⅱ及GL的影响

目的：比较单纯全麻和星状神经节阻滞术复合全麻对非体外循环冠状动脉旁路移植术（OPCABG）中应激反应的影响。方法：选择拟行OPCABG病人40例,根据实验设计随机分为星状神经节阻滞组（S组）和对照组（N组）各20例,S组在入室完成各项监测麻醉诱导前行右侧星状神经节阻滞术,两组麻醉及手术方式相同。分别于入室（T0,S组在行星状神经节阻滞前）、插气管导管（T1）、劈胸骨（T2）、和吻合前降支（T3）时记录患者的血压、脉搏并采中心静脉血测血糖,集中以放免法测促肾上腺皮质激素、血管紧张素Ⅱ和胰高血糖素。结果：与N组比较,S组患者各时点血流动力学变化更趋平稳;促肾上腺皮质激素和胰高血糖素的升高幅度明显较小（P〈0.01）。结论：星状神经节阻滞术可有效减轻OPCABG中麻醉与手术所致的过强应激反应。

Effects of Satellite Ganglion Block on the Hormone of Stress Response in Patients Undergoing Off-pump Coronary Artery Bypass Grafting

Objective： To compare the effect of general anesthesia combined with satellite ganglion block and general anesthesia on the hormone of stress response in patients undergoing off-pump coronary artery by pass grafting.Methods： 40 patients scheduled for off-pump coronary bypass graft were divided randomly into two groups.20 of them were given general anesthesia combined with satellite ganglion block as the study group（S group）.The others as the control group（N group） received general anesthesia only.When burglary（T0）,S group before satellite ganglion block）,endotracheal intubation（T1）,split sternum（T2） and take the left anterior descending artery（T3）,recorded the blood pressure and pulse,pumping center vein blood specimen measuring instantaneous blood glucose,concentration measured adrenocorticotropic hormone,angiotensin-Ⅱ and glucagon by radioimmunoassay.Results： Compared with the N group pa-tients of S group at each time point more stable hemodynamic changes;adrenocorticotropic hormone and glucagon elevated significantly smaller extent,P0.01.Conclusion： The technique of satellite ganglion block can effectively reduce the stress response caused by too strong of anesthesia and surgical in OPCABG.