目的

观察磷酸肌酸钠对心肌缺血老年手术患者动脉血氧分压、心肌酶及心律失常的影响。

方法

选择60 例术前心电图检查有心肌缺血的上腹部手术患者，ASA II～Ⅲ级,随机分成对照组和实验组，各30例。实验组麻醉后使用磷酸肌酸钠，对照组为生理盐水100 ml。两组均分别在麻醉后、术中1～2 h、术毕时行血气分析观察动脉血氧分压的改变，于术后24 h抽静脉血检测磷酸肌酸激酶同工酶（CPK-MB）和乳酸脱氢酶（LDH）水平，记录围术期Ⅱ导联心电图室性心律失常的发生情况。

结果

实验组术中1、2 h和术毕时各时点动脉血氧分压的增加均明显高于对照组；术后24 h心肌酶较术前均升高，但实验组上升幅度较对照组明显减小；围术期实验组室性心律失常的发生率较对照组低，差异有统计学意义（P 值均<0.05）。

结论

磷酸肌酸钠能提高心肌缺血老年患者围术期的动脉血氧分压，心肌酶得到明显改善，有效地减少室性心律失常的发生。

Objective

To investigate the influences of creatine phosphate on arterial oxygen partial pressure, cardiac enzymes and arrhythmia in senile patients with myocardial ischemia undergoing upper abdominal surgry.

Methods

Sixty myocardial ischemia patients,ASA scored II～III,were scheduled for upper abdominal sugery.They were randomly divided into control group(30 cases)and study group (30 cases).Creatine phosphate and 100 ml normal saline were intravenously given to study group and control group within 30 minutes after anesthesia respectively.Arterial oxygen partial pressure were observed right after anesthesia,1 and 2 hour during the operation and at the time of surgery finished through arterial blood gas analysis in the patients. Isoenzyme of creatine phosphokinase-MB(CPK-MB)and lactate dehydrogenase(LDH)levels in venous blood were tested 24 hours post-operation.WhileⅡ-lead electrocardiogram were recorded to monitor ventricular arrhythmia perioperatively.

Results

The increase of arterial oxygen partial pressure from the above time-points after anesthesia were higher in study group than that in control group(P<0.05).The cardiac enzyme levels increased in all patients,but the amplitudes were significantly lower in study group,incidence of perioperative ventricular arrhythmia was also significantly lower (P <0.05).

Conclusion

Creatine phosphate can effectively increase the arterial oxygen partial pressure, decrease the cardiac enzyme level and prevent ventricular arrhythmia in perioperative senile patients with myocardial ischemia.