犬硬膜外阻滞对腹部手术应激的初步研究
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摘要
目的：观察硬膜外阻滞下行腹部手术对犬血浆皮质醇、白细胞介素-2和血糖的影响。方法：16例犬腹部手术分成两组，硬膜外阻滞组(试验组，n=8)和硫喷妥钠静脉麻醉组(对照组，n=8)。分别于麻醉前(TO)、麻醉诱导后(T1)、切开腹壁时(T2)、手术30min(T3)、手术完毕时(T4)、手术后24h(T5)，手术后48h(T6)7个时间点静脉采血，采用放射免疫法测定之血浆皮质醉、白细胞介素-2浓度，比色法测定血糖浓度。结果：(1)对照组血浆皮质醇浓度平均值显著高于试验组(P＜0.05)；试验组各时间点与T0比较都无显著差异(P＞0.05)，对照组在T3、T4时血浆皮质醇浓度显著高于T0；两组相同时间血浆皮质醇浓度比较，对照组在T3、T4时显著高于试验组。(2)对照组血浆白细胞介素—2浓度平均值极显著低于试验组(P＜0.01)；试验组在T3、T4时血浆白细胞介素-2浓度显著高于T0，对照组在T5时显著低于T0；两组相同时间血浆白细胞介素-2浓度比较，对照组在T1、T2、T5和T6时显著低于试验组。(3)对照组血糖浓度平均值显著高于试验组：试验组在T4时血糖浓度显著高于T0，对照组在T3、T4、T5和T6时显著高于T0；两组相同时间血糖浓度比较，对照组在T4时显著高于试验组。结论：硬膜外阻滞与硫喷妥钠静脉麻醉比较，硬膜外阻滞能够更有效缓解犬腹部手术的应激反应。
Objective: to study the effects of epidural block on plasma cortisol, interIeukin-2 and blood sugar to abdominal operations in dogs. Methods: 16 abdominal operations of dogs were divided into two groups: epidural block (experiment group, n1=8) and pentothal sodium intravenous anesthesia (control group, n2=8). Blood samples were taken pre-inductively ( T0), post-inductively ( T1), immediately after open abdomen( T2 ), 30 minutes post operatively ( T3 ), at the end of operation ( T4 ), 24 hours post operatively ( T5 ) and 48 hours post operatively( T6 ) The levels of plasma cortisol, interleukin-2 and blood sugar were measured by radioimmunoassay and colorimetric assay, respectively. Results: (1) The average level of plasma cortisol in control group was significantly higher than that of experiment group ( P< 0.05 ); there was no significant difference to T0 in experiment group at various time (P>0.05 ), while the levels at time T3 and T4 were significantly higher than T0 in control group; the plasma cortisol l
evel in control group was significantly higher than that in experiment group at the time of T4. (2) The average level of plasma interleukin-2 in control group was significantly lower than that in experiment group ( P< 0.01 ); the levels at time T3 and T4 were significantly higher than that at TO in experiment group, whereas in control group, the level at time T5 was significantly lower than TO; the plasma interleukin-2 level in control group was significantly lower than that in experiment group at the time of T2, T3,T5 and T6. (3) The average level of blood sugar in control group was significantly higher than that in experiment group; the level at time T4 was significantly higher than TO in experiment group, and the same at time T3, T4, T5 in control group; the blood sugar level in control group was significantly higher than that of experiment group at the time of T4. Conclusion: The stress response to abdominal operations in dogs could be relieved more effectively by epidural block than by pentothal sodium
intravenous anesthesia.
Objective: to study the effects of epidural block on plasma cortisol, interIeukin-2 and blood sugar to abdominal operations in dogs. Methods: 16 abdominal operations of dogs were divided into two groups: epidural block (experiment group, n1=8) and pentothal sodium intravenous anesthesia (control group, n2=8). Blood samples were taken pre-inductively ( T0), post-inductively ( T1), immediately after open abdomen( T2 ), 30 minutes post operatively ( T3 ), at the end of operation ( T4 ), 24 hours post operatively ( T5 ) and 48 hours post operatively( T6 ) The levels of plasma cortisol, interleukin-2 and blood sugar were measured by radioimmunoassay and colorimetric assay, respectively. Results: (1) The average level of plasma cortisol in control group was significantly higher than that of experiment group ( P< 0.05 ); there was no significant difference to T0 in experiment group at various time (P>0.05 ), while the levels at time T3 and T4 were significantly higher than T0 in control group; the plasma cortisol l
evel in control group was significantly higher than that in experiment group at the time of T4. (2) The average level of plasma interleukin-2 in control group was significantly lower than that in experiment group ( P< 0.01 ); the levels at time T3 and T4 were significantly higher than that at TO in experiment group, whereas in control group, the level at time T5 was significantly lower than TO; the plasma interleukin-2 level in control group was significantly lower than that in experiment group at the time of T2, T3,T5 and T6. (3) The average level of blood sugar in control group was significantly higher than that in experiment group; the level at time T4 was significantly higher than TO in experiment group, and the same at time T3, T4, T5 in control group; the blood sugar level in control group was significantly higher than that of experiment group at the time of T4. Conclusion: The stress response to abdominal operations in dogs could be relieved more effectively by epidural block than by pentothal sodium
intravenous anesthesia.
引文
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2. Selye H. Selye's Guide to Stress Research [M]. New York: Van Nostrand Reinhold Co., 1980:32
3．杨惠玲，潘景轩，吴伟康．高级病理生理学[M]．北京：科学出版社，1998，10：175
4．刘克嘉．应激与应激性疾病[M]．北京：人民军医出版社，1992，3：5
5. Bertók L. Bacterial endotoxins and nonspecific resistance[J]. Acta Microbiol Immunol Hung, 1997, 44(4): 361～365
6．陈主初．病理生理学[M]．北京：人民卫生出版社，2001，8：183
7．谭基明．外科病理生理学[M]．北京：人民卫生出版社，1998，2：79
8．徐道妙，谭秀娟．围麻醉期应激反应及其调控[J]．国外医学：麻醉学与复苏分册，1994，16(4)：207～210
9．周小军，田道法，孙广华．内稳态、疾病及治疗[J]．南京中医药大学学报(社科版)．2000，1(3)：123～125
10．赵景海．现代理论医学与中医基础理论的联系[J]．哲里木畜牧学院学报，1998，8(2)：72～75
11．宋为民，王明艳，徐力．基因组学是中医现代化的最佳切入点[M]．南京中医药大学学报，1999，15(4)：193～195
12．吴晓春．论中医学中的内稳态[J]．湖南中医杂志．1997，13(3)：8～9
13．黄荣国．关于证与人体功能关系的方法论研究——证是人体各具特征的疾病功能态[J]．中国人体科学，1996，6(1)：21～23．
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