摘要
目的观察七氟醚静脉-吸入复合麻醉与全凭静脉麻醉对肝脏部分切除患者术后苏醒质量的影响。方法选择2016年1月至2016年4月于本院择期行肝脏部分切除手术的肝脏肿瘤患者40例为研究对象,随机分为七氟醚组和对照组,每组各20例。七氟醚组患者接受七氟醚静脉-吸入复合麻醉,对照组患者接受全凭静脉麻醉,两组患者手术方式一致。术毕分别检测并比较两组患者外周血白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平;记录两组患者睁眼时间、拔管时间、麻醉恢复室(post anesthesia care unit,PACU)停留时间及离开PACU后12、24及48小时的简易精神状况检查(minimental state examination,MMSE)评分。结果七氟醚组患者的睁眼时间、拔管时间及PACU停留时间[(24.7±7.8)分钟、(44.3±8.6)分钟、(57.2±14.6)分钟]均略短于对照组[(28.7±12.9)分钟、(50.7±16.8)分钟、(65.6±20.8)分钟],但组间比较差异均无显著性(P>0.05);七氟醚组患者离开PACU后12、24及48小时的MMSE评分[(24.9±1.7)分、(25.1±0.9)分、(26.7±1.5)分]均显著高于对照组[(23.3±1.4)分、(24.1±1.2)分、(26.3±1.3)分](P<0.05),术后外周血IL-6和TNF-α水平均显著低于对照组(P<0.05)。结论七氟醚静脉-吸入复合麻醉可以通过减轻肝脏部分切除术后的炎性反应及缺血再灌注损伤,提高患者的苏醒质量,适用于创伤较大的肝脏部分切除术。
Objective To investigate the impact on quality of awakening of two different anesthesia methods： combined intrarenous and inhalation anesthesia and total intravenous anesthesia. Method 40 cases of liver cancer （malignant and benign） patients who received elective liver resection surgery in our hospital from January 2016 to April 2016 were randomly divided into treatment group and control group, 20 cases each. Treatment group patients received combined intravenous and inhalation anesthesia, while control group patients received total intravenous anesthesia. The manner of operation between different groups kept constant. After operation, measured and compared two groups of patients with peripheral blood interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） levels. Patients＇ eye opening time, the residence time in post anesthesia care unit were recorded, the MMSE score after leaving post anesthesia care unit （PACU） for 12, 24 and 48 hours were recorded as well. Result The patients eye opening, extubation time and time off PACU of treatment group [（24.7 ±7.8） rain, （44.3±8.6） min, （57.2±14.6） mini were slightly shorter than control group [（28.7 ±12.9） min, （50.7±16.8） min, （65.6±20.8） min], but the differences were not significant （P 〉 0.05）; while the MMSE score of control group patients at 12, 24 and 48 hour after surgery [（24.9±1.7） points, （25.1 ±0.9） points and （26.7± 1.5） points] were significantly higher than control group [（23.3±1.4） points, （24.1± 1.2） points, （26.3±1.3） points] （P 〈 0.05）; at the same time, inflammatory cytokines IL-6 and TNF-α levels in the peripheral blood of treatment group patients were significantly lower than control group （P 〈 0.05）. Conclusion Combined intravenous and inhalation anesthesia can improve the quality of awakening by alleviating hepatic ischemia reperfusion injury, and it is suitabte for large liver resection surgery.
作者
徐露
柴小青
XU Lu CHAI Xiao-qing(Department of Anesthesia, Anhui Provincial Hospital, Hefei 230001, China)
出处
《中国医学前沿杂志（电子版）》
2016年第11期105-108,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
肝脏手术
七氟醚
静脉-吸入复合麻醉
缺血再灌注损伤
Partial hepatic resection
Sevoflurane
Combined intravenous and inhalation anesthesia
Ischemia-reperfusion injury
