七氟醚、异氟醚或丙泊酚全身麻醉复合硬膜外阻滞对肝脏切除术后肝肾功能的影响被引量：34

Comparison of the effects of sevoflurane,isoflurane and propofol TCI combined with epidural block on renal and hepatic function during partial hepatectomy

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摘要目的探讨低流量七氟醚、异氟醚或丙泊酚全麻复合硬膜外阻滞在相同脑电双频指数下三种麻醉方法对术后肝肾功能的影响。方法选择45例ASAI或II级,肝脏右叶部分切除病人,随机均分为七氟醚组(S组)、异氟醚组(I组)和丙泊酚组(P组),每组病人均复合硬膜外阻滞。三组病人分别吸入七氟醚、异氟醚或丙泊酚靶控输注(TCI)维持麻醉,维持BIS50±5。记录术前、术后第1、3、5天肝脏功能、肾脏功能指标。结果三组病人术后第1、3、5天肝脏酶显著增高,在术后第1天达到高峰,总胆红素术后第3天达高峰,白蛋白术后第1天显著降低,术后第3天和第5天与术前比较差异无统计学意义。三组病人均无肝功能衰竭。术后肾脏功能指标肌酐、尿素氮组内、组间比较差异均无统计学意义。结论应用全身麻醉复合硬膜外阻滞进行肝脏部分切除手术,七氟醚、异氟醚或丙泊酚对肝脏术后肝功能改变无明显区别,术后肾脏功能无明显变化。 Objective To compare the effects of sevoflurane,isoflurane and propofol anesthesia combined with epidural block on renal and hepatic function in patients underwent partial hepatectomy. Methods Forty-five patients ASA class I or II scheduled for right liver segmentectomy were assined into three groups with 15 cases each. The patients in group S, I and P were given sevoflurane, isoflurane and propofol,respectively,for the maintenance of anesthesia keeping a similar BIS value of 50 ± 5. The general anesthesia was combined with epidural block in all three groups. Renal and hepatic functions were measured before and on the lst,3rd,and 5th day after surgery. Results There were no significant differences in hepatic function tests among three groups. No patient developed hepatic failure. Blood urea nitrogen and serum creatinine were within the normal range in all groups. Conclusion Low flow sevoflurane,isoflurane or propofol anesthesia combined with epidural block has the same effect on the renal and hepatic function in patients underwent partial hepatectomy.

作者沈洪苏子敏仓静王婷缪长虹薛张纲

机构地区复旦大学附属中山医院麻醉科

出处《临床麻醉学杂志》 CAS CSCD 2007年第8期624-626,共3页 Journal of Clinical Anesthesiology

关键词七氟醚异氟醚丙泊酚全身麻醉硬膜外阻滞肝肾功能 Sevoflurane Isoflurane Propofol General anesthesia Epidural block Renal and hepatic function

分类号 R614 [医药卫生—麻醉学]

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