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0.2mg·kg^-1顺苯磺酸阿曲库胺和0.4μg·kg^-1舒芬太尼静脉注射;丙泊酚组所有患者将1-2mg·kg^-1丙泊酚、0.2mg·kg^-1顺苯磺酸阿曲库胺和0.4μg·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0.5-0.8mg·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1d（T2）、3d（T3）和5d（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CystatinC和24h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CystatinC和24h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。
Objective To investigate the effect of anesthesia combined with sevoflurane inhalation on liver and kidney function in pa-tients 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% sevoflu-rane,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 -atracuri-um 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 in-creased,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 C and 24 h urine albumin in the two groups at T2 -4 were increased,and the differences were statistically significant （P 〈0.05）.Cystatin C and 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.
出处
《安徽医药》
CAS
2016年第2期374-377,共4页
Anhui Medical and Pharmaceutical Journal
关键词
肝叶切除术
七氟醚
丙泊酚
肝肾功能
hepatic, lobectomy
sevoflurane
propofol
liver and kidney function
