七氟醚对老年食管癌患者心肌保护作用.docVIP

七氟醚对老年食管癌患者的心肌保护作用 　　[摘要] 目的 探讨七氟醚吸入麻醉与丙泊酚静脉麻醉对老年患者围术期的心肌保护作用。 方法 选择2014年3月～2015年3月于我院行食管癌根治术的老年患者40例，按随机数字表法将其分为七氟醚吸入麻醉组（S组）和丙泊酚静脉麻醉组（P组），每组20例，比较两组患者不同时间点的血清心肌肌钙蛋I（cTnI）、microRNA-499、microRNA-208b水平。 结果 ①P组T2、T3、T4时刻的cTnI含量均高于S组，差异有统计学意义（P0.05）；②P组T3时刻的microRNA-499和microRNA-208b含量均高于S组，差异有统计学意义（P0.05）。 结论 七氟醚吸入麻醉较丙泊酚静脉麻醉更具心肌保护作用，对减少老年患者围术期心脏并发症有重要的意义。 　　[关键词] 七氟醚；食管癌；心肌保护 　　[中图分类号] R971+.2 [文献标识码] A [文章编号] 1674-4721（2016）05（b）-0093-03 　　[Abstract] Objective To investigate the myocardial protective effect of sevoflurane inhalation anesthesia on perioperative period of elderly patients with propofol intravenous anesthesia. Methods 40 elderly patients who were given radical surgery for esophageal cancer in our hospital from March 2014 to March 2015 were selected.They were assigned to the group of inhalation anesthesia with sevoflurane （group S） and the group of intravenous anesthesia with propofol （group P） according to the random number table，with 20 patients in each group.The cTnI level and microRNA-499 and microRNA-208b levels at different time points were compared between the two groups of patients. Results ①The contents of cTnI in group P at the T2，T3，T4 was higher than that in group S respectively，and the differences was statistically significant（P0.05）.②The contents of microRNA-499 and microRNA-208b at the T3 in group P was higher than that in group S respectively，and the differences was statistically significant（P0.05）. Conclusion Inhalation anesthesia with sevoflurane has better myocardial protection effects than intravenous anesthesia with propofol，and it has great significance in reducing the cardiac complications in elderly patients during the perioperative period. 　　[Key words] Sevoflurane；Esophageal cancer；Myocardial protection 　　食管癌是人类常见的恶性肿瘤之一。在我国，食管癌死亡率占恶性肿瘤死因的11.19%，居我国恶性肿瘤的第4位[1]，给民众生命构成极大威胁。目前，食管癌的治疗仍以手术为主[2]，但开胸食管癌根治术给机体带来激烈应激和创伤，易导致患者术后出现心肌损伤。近年来，有研究[3-4]报道，吸入麻醉药七氟醚在心肌保护方面存在明显优势，但目前国内外关于七氟醚对老年食管癌患者围术期心脏功能保护作用的研究不多，本文通过比较七氟醚吸入麻醉与丙泊酚静脉麻醉在老年