| 杜小兵.七氟醚静吸复合麻醉对肝叶切除术患者肝肾功能的影响[J].安徽医药,2016,20(2):374-377. |
| 七氟醚静吸复合麻醉对肝叶切除术患者肝肾功能的影响 |
| Effect of anesthesia combined with sevoflurane inhalation on liver and kidney function in patients treated with hepatic lobectomy |
| 投稿时间：2015-09-29 |
| DOI： |
| 中文关键词: 肝叶切除术 七氟醚 丙泊酚 肝肾功能 |
| 英文关键词: hepatic lobectomy sevoflurane propofol liver and kidney function |
| 基金项目: |
|
| 摘要点击次数: 2505 |
| 全文下载次数: 95 |
| 中文摘要: |
| 目的 探讨七氟醚静吸复合麻醉对肝叶切除术患者肝肾功能的影响。方法 85例择期行开腹肝叶切除术患者随机分为七氟醚组(n=44)和丙泊酚组(n=41),麻醉诱导:七氟醚组所有患者吸入8%七氟醚,等意识丧失后,用0.2 mg·kg-1顺苯磺酸阿曲库胺和0.4 μg·kg-1舒芬太尼静脉注射；丙泊酚组所有患者将1～2 mg·kg-1丙泊酚、0.2 mg·kg-1顺苯磺酸阿曲库胺和0.4 μg·kg-1舒芬太尼静脉注射。麻醉维持:七氟醚组患者持续吸入2%～3%七氟醚,丙泊酚组患者将0.5～0.8 mg·kg-1·h-1丙泊酚持续静脉输注,维持BIS值在40～60之间。记录两组患者手术一般情况,分别于麻醉诱导前(T0)、术毕(T1)、术后1 d(T2)、3 d(T3)和5 d(T4)时,检测两组患者肝肾功能指标。结果 与T0时相比,两组患者T1～4时ALT升高,T1～3时AST升高,T2～4时TBil和DBil升高,T2时ALB降低,差异均有统计学意义(P<0.05)；七氟醚组患者T2～4时ALT、TBil和DBil均低于丙泊酚组,T2～3时AST低于丙泊酚组,T2时ALB高于丙泊酚组,差异均有统计学意义(P<0.05)；与T0时相比,两组患者T2～4时Cystatin C和24 h尿微量白蛋白均升高,差异均有统计学意义(P<0.05)；七氟醚组患者T2～4时Cystatin C和24 h尿微量白蛋白均低于丙泊酚组,差异均有统计学意义(P<0.05)。结论 相比于丙泊酚复合麻醉,七氟醚静吸复合麻醉更有利于减轻肝叶切除术中缺血—再灌注损伤对患者肝肾功能的影响。 |
| 英文摘要: |
| Objective To investigate the effect of anesthesia combined with sevoflurane inhalation on liver and kidney function in patients treated with hepatic lobectomy.Methods 85 cases treated with elective opening hepatic lobectomy were randomly divided into sevoflurane group (n=44) and propofol group (n=41).Induction of anesthesia:patients in sevoflurane group inhaled 8% sevoflurane,and then 0.2 mg·kg-1 of cis-atracurium sulfonic acid amine and 0.4 μg·kg-1 sufentanil were intravenously injected upon consciousness loss.Patients in propofol group were intravenously injected with 1~2 mg·kg-1 propofol,0.2 mg·kg-1 of cis-atracurium sulfonic acid amine and 0.4 μg·kg-1 sufentanil.Maintenance of anesthesia:the sevoflurane group continued to inhale 2%~3% sevoflurane,while the propofol group were treated with continuous infusion of 0.5~0.8 mg·kg-1·h-1 propofol,and the BIS value was maintained around 40 and 60.Results Compared with T0,ALT in the two groups at T1~4 was increased,AST at T1~3 was increased,TBil and DBil at T2~4 were increased,and ALB at T2 was decreased (P<0.05).In the sevoflurane group,ALT,TBil and DBil at T2~4 were lower than the propofol group,AST at T2~3 were lower than the propofol group,and ALB at T2 was higher than propofol group (P<0.05).Compared with T0,Cystatin Cand 24 h urine albumin in the two groups at T2~4 were increased,and the differences were statistically significant (P<0.05).Cystatin Cand 24 h urinary albumin in the sevoflurane group at T2~4 were lower than the propofol group(P <0.05).Conclusions Compared with propofol combined with anesthesia,sevoflurane inhalation with anesthesia was more efficient to alleviate the effects of ischemic-reperfusion injury caused by hepatic lobectomy on liver and kidney function. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
