Objective To investigate the effects of seven halothane and propofol anesthesia on heart rate and myocardial enzymes in elderly patients with coronary heart disease (CHD), and to analyze the safety of clinical application of the two kinds of anesthetic drugs.MethodsA total of 70 cases of elderly patients with coronary heart disease treatment January 2012 to December 2014 general anesthesia surgery as the research object, randomly divided into A group and B group were 35 patients in.A group were treated with seven sevoflurane anesthesia, group B patients were given propofol anesthesia, observe the change of the two groups of patients before and after anesthesia hemodynamic index and myocardial enzyme etc.index.ResultsA group of patients with HR 5min after induction and 10min were significantly lower than before the surgery, and the difference was statistically significant (P<0.05);HR stabilized after the induction of 15min and 20min, and compared with before surgery had no significant difference;patients in group B HR and 10min 5min after induction there was no obvious change compared with that before operation, no statistical significance;and after the induction of 15min and 20min HR increased, the difference was statistically significant (P<0.05).A group and B group in patients with systolic and diastolic blood pressure were lower than before anesthesia in varying degrees, and group B more significantly, the difference was statistically significant (P<0.05).A group and B group of patients after 6 h, cTnl and CK-MB in 12h and 24h than 15min before surgery has increased significantly, and A group cTnl and CK-MB were lower than B group, the difference was statistically significant (P<0.05).ConclusionThe clinical application of seven sevoflurane anesthesia for elderly patients with coronary heart disease during propofol is feasible, but seven halothane on blood pressure and heart rate of patients affected with propofol, improve the myocardial enzyme level, and better reduce the damage of perioperative myocardial, more suitable for anesthesia in elderly coronary heart disease.%目的 探讨七氟烷、丙泊酚麻醉对老年冠状动脉粥样硬化性心脏病(冠心病)患者的心率与心肌酶影响,分析2种麻醉药物在临床中的应用安全性.方法 选取2012年1月~2014年12月全麻手术治疗的70例老年冠心病患者为研究对象,将其按照随机数字表法分为A组和B组,均35例.A组患者给予七氟烷麻醉,B组患者给予丙泊酚麻醉,观察2组患者麻醉前后血流动力学指标和心肌酶等指标的变化.结果 A组患者HR在诱导后5min和10min较手术前有明显的降低,且差异有统计学意义(P<0.05);在诱导15min和20min之后HR恢复稳定,且与手术前比较差异无统计学意义;B组患者HR在诱导后5min和10min较手术前无明显的变化,统计学无意义;而在诱导15min和20min之后HR出现增加,差异有统计学意义(P<0.05).A组和B组患者诱导后收缩压和舒张压均较麻醉前均有不同程度的降低,且B组降低更明显,差异有统计学意义(P<0.05).A组和B组患者术后6h、12h和24h的cTnl和CK-MB含量较手术前15min有明显的提高,且A组cTnl和CK-MB含量低于B组,差异有统计学意义(P<0.05).结论 临床中对于老年冠心病患者麻醉过程中应用七氟烷与丙泊酚均是可行的,但是七氟烷对患者血压和心率影响较丙泊酚小,改善心肌酶的水平,且更好的减少对围手术期心肌的损害,更适合老年冠心病的麻醉.
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