發(fā)布時(shí)間：2018-03-21 13:03

  本文選題：七氟醚　切入點(diǎn)：異氟醚　出處：《首都醫(yī)科大學(xué)學(xué)報(bào)》2017年03期 　論文類型：期刊論文

【摘要】：目的探討不同麻醉藥物行全身麻醉復(fù)合硬膜外阻滯對(duì)肝臟切除術(shù)后肝腎功能的影響。方法選取首都醫(yī)科大學(xué)附屬北京地壇醫(yī)院2014年10月至2015年10月全身麻醉復(fù)合硬膜外阻滯下肝臟切除術(shù)病人123例。采用數(shù)字表法隨機(jī)抽樣將研究對(duì)象分為3組(每組41例),A組病人采用七氟醚吸入全身麻醉,B組病人采用異氟醚吸入全身麻醉,C組病人采用丙泊酚靜脈全身麻醉,比較3組病人不同時(shí)間點(diǎn)肝腎功能指標(biāo)。結(jié)果術(shù)后3組病人丙氨酸氨基轉(zhuǎn)移酶(alanine aminotransferase,ALT)、門冬氨酸氨基轉(zhuǎn)移酶(aspartate transaminase,AST)、堿性磷酸酶(alkaline phosphatase,ALP)、總膽紅素(total bilirubin,TBi L)、γ-谷氨酰轉(zhuǎn)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)、乳酸脫氫酶(lactic dehydrogenase,LDH)均表現(xiàn)為升高后降低(P0.05)。B組病人術(shù)后1、3 d時(shí)ALT、AST、ALP、TBi L、γ-GT、BUN、SCr、α1-MG、ALB、LDH高于A組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。C組病人術(shù)后1 d、3 d時(shí)ALT、AST、ALP、TBi L、γ-GT、BUN、SCr、α1-MG、ALB、LDH高于A組和B組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論肝臟切除術(shù)中,七氟醚、異氟醚、丙泊酚均可用于全身麻醉復(fù)合硬膜外阻滯。七氟醚對(duì)病人術(shù)后肝腎功能的影響更小,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), 緯 -glutamyltranspeptidase (緯 -GT), urea were compared in three groups of patients at different time points after operation. Serum creatinine scrr, 偽 1-microglobulin (偽 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, 緯 -GTBUNSCr, 偽 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, 偽 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, 偽 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, 緯 -GTU BUNSCr, 偽 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.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京地壇醫(yī)院麻醉科;
【基金】：首都醫(yī)科大學(xué)附屬北京地壇醫(yī)院院內(nèi)“啟航計(jì)劃”(DTQH201405)~~
【分類號(hào)】：R614

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