气管插管后七氟醚预处理麻醉对肝门阻断术中患者的肠保护作用

发布时间：2018-02-11 11:44

本文关键词： 肠保护肝门阻断术七氟醚炎性反应　出处：《新乡医学院学报》2016年04期 　论文类型：期刊论文

【摘要】：目的评价气管插管后七氟醚预处理对行肝门阻断术患者肠道的保护作用。方法选择解放军总医院第一附属医院确诊为右肝癌的患者52例,美国麻醉医师协会分级Ⅱ~Ⅲ级,肝功能分级A级,按照随机对照原则分为对照组和七氟醚组,每组26例,2组患者在术中均行肝门阻断术,其中七氟醚组患者在气管插管后给予七氟醚吸入麻醉,对照组患者未采取吸入麻醉措施。对2组患者的术中情况及麻醉诱导前(T_1)、肝门阻断时(T_2)、肝门开放后1 h(T_3)、3 h(T_4)、6 h(T_5)和术后24 h(T_6)时的血清肿瘤坏死因子-α(T_NF-α)、D乳酸盐、肠脂肪酸结合蛋白(I-FABP)水平进行检测分析。结果 2组患者的手术时间、术中出血量、肿瘤切除直径、肝门阻断时间比较差异均无统计学意义(P0.05)。2组患者血清T_NF-α、D乳酸盐水平均从T_3时开始上升,T_5时达到最高水平。而血清I-FABP水平从T_3时开始上升,T_4时达到最高水平。七氟醚组患者T_3~T_6时血清T_NF-α、D乳酸盐及I-FABP均显著低于对照组(P0.05)。结论气管插管后七氟醚预先吸入麻醉能够显著抑制机体的炎性反应,从而在肝门阻断术中对肠道产生一定的保护作用。
[Abstract]:Objective to evaluate the protective effect of sevoflurane preconditioning after tracheal intubation on intestinal tract of patients undergoing hepatic hilar occlusion. Methods 52 patients with right liver cancer diagnosed in the first affiliated Hospital of PLA General Hospital were selected. Liver function grade A was divided into control group and sevoflurane group according to the principle of random control. 26 patients in each group were treated with hepatic portal occlusion during operation, and the patients in sevoflurane group were given sevoflurane inhalation anesthesia after tracheal intubation. The patients in the control group were given no inhaled anesthesia. The intraoperative condition of the patients in both groups and the level of T _ 1 before anesthesia induction were compared. The levels of serum tumor necrosis factor- 伪 TNF- 伪 -ndlactic acid at 1 hour after hepatic hilus occlusion, 1 hour after hepatic hilus opening, 1 hour after hepatic hilum opening, 3 h after hepatic hilar opening and 6 h after operation, and 24 h after operation (24 h after operation) were compared with those of the patients in the control group, and the levels of serum tumor necrosis factor- 伪 TNF- 伪 -tid lactate were observed in the patients of the two groups. Results the operative time, intraoperative blood loss and tumor resection diameter were measured and analyzed in the two groups. There was no significant difference in the clamping time of hepatic hilus between the two groups. There was no significant difference between the two groups. The serum TNF- 伪 -tid lactate increased from T3 to T5, and the serum I-FABP increased from T3 to T4 and reached the highest level from T3 to T4. The levels of serum TNF- 伪 D lactate and I-FABP in the ether group were significantly lower than those in the control group at T _ 3 and T _ 6. Conclusion preinhalation anesthesia with sevoflurane after tracheal intubation can significantly inhibit the inflammatory response of the body. Thus, the hepatic hilus occlusion has a certain protective effect on the intestinal tract.
【作者单位】：中国人民解放军总医院第一附属医院麻醉科;
【分类号】：R614

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