不同麻醉药物行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

发布时间：2018-03-21 13:03

本文选题：七氟醚　切入点：异氟醚　出处：《首都医科大学学报》2017年03期 　论文类型：期刊论文

【摘要】：目的探讨不同麻醉药物行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。方法选取首都医科大学附属北京地坛医院2014年10月至2015年10月全身麻醉复合硬膜外阻滞下肝脏切除术病人123例。采用数字表法随机抽样将研究对象分为3组(每组41例),A组病人采用七氟醚吸入全身麻醉,B组病人采用异氟醚吸入全身麻醉,C组病人采用丙泊酚静脉全身麻醉,比较3组病人不同时间点肝肾功能指标。结果术后3组病人丙氨酸氨基转移酶(alanine aminotransferase,ALT)、门冬氨酸氨基转移酶(aspartate transaminase,AST)、碱性磷酸酶(alkaline phosphatase,ALP)、总胆红素(total bilirubin,TBi L)、γ-谷氨酰转肽酶(γ-glutamyltranspeptidase,γ-GT)、尿素氮(urea nitrogen,BUN)、血肌酐(serum creatinine,SCr)、α1-微球蛋白(α1-microglobulin,α1-MG)、白蛋白(albumin,ALB)、乳酸脱氢酶(lactic dehydrogenase,LDH)均表现为升高后降低(P0.05)。B组病人术后1、3 d时ALT、AST、ALP、TBi L、γ-GT、BUN、SCr、α1-MG、ALB、LDH高于A组,差异有统计学意义(P0.05)。C组病人术后1 d、3 d时ALT、AST、ALP、TBi L、γ-GT、BUN、SCr、α1-MG、ALB、LDH高于A组和B组,差异有统计学意义(P0.05)。结论肝脏切除术中,七氟醚、异氟醚、丙泊酚均可用于全身麻醉复合硬膜外阻滞。七氟醚对病人术后肝肾功能的影响更小,安全性更高。
[Abstract]:Objective to investigate the effect of general anesthesia combined with epidural block with different anesthetic drugs on liver and kidney function after hepatectomy. Methods General anesthesia combined with general anesthesia was selected from October 2014 to October 2015 in The Temple of Earth Hospital affiliated to Capital Medical University. 123 patients undergoing liver resection under epidural block were randomly divided into 3 groups (41 patients in each group were given sevoflurane inhalation general anesthesia and group B received isoflurane inhalation general anesthesia). Patients in group C received intravenous general anesthesia with propofol. Results Alanine aminotransferase (alt), aspartate transaminase (AST), alkaline phosphatase (ALP), total bilirubin (TBI), 纬 -glutamyltranspeptidase (纬 -GT), urea were compared in three groups of patients at different time points after operation. Serum creatinine scrr, 伪 1-microglobulin (伪 1-MGG), albumin Albumin (Alb), lactate dehydrogenase (LDH) in group A were significantly lower than those in group A (P 0.05.B) on the 1th day after operation. The levels of ALTASTN TBi, 纬 -GTBUNSCr, 伪 1-MGG ALBU LDH in group B were significantly higher than those in group A (P 0.05.B) after operation, the levels of serum creatinine, 伪 1-MGG, ALB and LDH in group A were significantly higher than those in group A (P 0.05.B) after operation, the levels of serum creatinine, 伪 1-MGG, ALB and LDH were higher than those in group A. There was a significant difference between group A (P 0.05) and group C (P 0.05) on the 3rd day after operation. Conclusion the levels of ALPBi L, 纬 -GTU BUNSCr, 伪 1-MGG, ALBN LDH in group A and B are higher than those in group A and B, and the difference is statistically significant (P 0.05). Conclusion in hepatectomy, sevoflurane, isoflurane, sevoflurane, isoflurane, sevoflurane, isoflurane, Propofol can be used in general anesthesia combined with epidural block. Sevoflurane has less effect on liver and kidney function and higher safety.
【作者单位】：首都医科大学附属北京地坛医院麻醉科;
【基金】：首都医科大学附属北京地坛医院院内“启航计划”(DTQH201405)~~
【分类号】：R614

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