七氟醚与异氟醚对肝硬化患者肝脏缺血-再灌注损伤的影响

发布时间：2018-04-10 20:49

本文选题：七氟醚 + 异氟醚　；参考：《临床麻醉学杂志》2015年07期

【摘要】：目的比较七氟醚和异氟醚麻醉对肝硬化患者肝脏缺血-再灌注损伤的影响。方法60例择期行肝脏部分切除的肝硬化患者,随机均分为七氟醚组(S组)和异氟醚组(I组),每组30例。两组患者麻醉诱导均静脉注射舒芬太尼0.4μg/kg、依托咪酯0.2~0.3mg/kg和顺苯磺酸阿曲库铵0.2~0.3mg/kg。S组和I组均维持麻醉药呼气末浓度为1.0 MAC,间断静注舒芬太尼、顺苯磺酸阿曲库铵维持麻醉。分别于麻醉诱导前(T0)、肝门阻断前(T1)、阻断开放后即刻(T2)、60 min(T3)、术后1d(T4)、术后3d(T5)取中心静脉血,测定血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、总超氧化物歧化酶(T-SOD)和丙二醛(MDA)的水平。结果与T0及T1时比较,T3~T5时两组AST、ALT含量明显升高(P0.05);T4、T5时两组T-SOD含量明显降低,MDA含量明显升高(P0.05);T3~T5时S组AST、ALT含量明显低于I组(P0.05),T4、T5时T-SOD含量明显高于、MDA含量明显低于I组(P0.05)。结论七氟醚可减轻肝硬化患者肝缺血-再灌注损伤的程度,较适用于肝硬化患者行肝脏部分切除术。
[Abstract]:Objective to compare the effects of sevoflurane and isoflurane anesthesia on hepatic ischemia reperfusion injury in patients with liver cirrhosis.Methods Sixty patients with liver cirrhosis undergoing partial hepatectomy were randomly divided into sevoflurane group (S group) and isoflurane group (n = 30).Sufentanil (0.4 渭 g / kg) was injected intravenously in both groups. Etomidate 0.2~0.3mg/kg and atracurium maleate (0.2~0.3mg/kg.S) and group I (group I) maintained the end expiratory concentration of 1. 0 MAC.The intravenous injection of sufentanil and atracurium cisbenzenesulfonate were used to maintain anesthesia.Serum levels of alanine aminotransferase (alt), aspartate aminotransferase (ASTT), total superoxide dismutase (T-SOD) and malondialdehyde (MDA) were measured before anesthesia induction and hepatic porta occlusion.Conclusion sevoflurane can reduce the degree of hepatic ischemia reperfusion injury in patients with liver cirrhosis and is more suitable for partial hepatectomy in patients with liver cirrhosis.
【作者单位】：江苏省张家港市第一人民医院麻醉科;
【分类号】：R614

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