摘要
目的:探讨七氟醚麻醉时对氧自由基及肾功能的影响。方法:选择非泌尿系统手术的全麻患者60例,ASA I^II级,20~40岁,随机分为3组,每组20例。A:全凭静脉组,B:全凭吸入组,C:静吸复合组。B组为观察组,A、C组为对照组。在麻醉诱导前即刻、诱导后1、2h和术后一天抽取静脉血,检测血清超氧化物歧化酶(SOD)活性、丙二醛(MDA)浓度和血清尿素氮(BUN)和血清肌酐(Cr)含量。结果:B组SOD均逐渐下降;MDA均逐渐升高,差异有显著性(P<0.05);BUN、Cr有所升高且达正常值上限,但差异无显著性(P>0.05)。A、C两组SOD值均有下降但差异无显著性(P>0.05);MDA值均逐渐降低,差异有显著性(P<0.05);BUN、Cr值无明显变化。A、C两组间相比较,SOD、MDA值差异无显著性(P>0.05);BUN、Cr值差异也无显著性(P>0.05)。A、B组之间及B、C组之间相比较,SOD、MDA值差异有显著性(P<0.05);BUN、Cr值差异无显著性(P>0.05)。结论:(1)七氟醚能产生自由基,有潜在的、轻度的肾毒性。(2)临床麻醉剂量的丙泊酚能有效清除自由基,对七氟醚所致肾脏损伤有明显的保护作用。(3)七氟醚复合丙泊酚麻醉是一种理想的静吸麻醉方法。
Objective：To investigate the effects of sevoflurane anesthesia on oxygen free radical and renal function.Methods：Sixty ASA I ~II patients,aged 20~40 years undergoing general anesthesia of non-urinary system surgery,were randomly divided into 3 groups（n=20 each）.Group A was total intravenous anesthesia,Group B was total inhalation anesthesia and Group C was intravenous-inhalation combined anesthesia.Group B was the observation group and Groups A and C were the control group.Venous blood samples were taken immediately before induction of anesthesia（T0）at 1 and 2h after induction（T1,2）and postoperative day（T3）for the determination of serum SOD activity,MDA concentration and serum BUN and Cr levels.Results：In Group B,the SOD value was gradually decreased,the MDA value was gradually increased,with a significant difference（P〈0.05） and the BUN and Cr values were slightly increased,reaching the normal limit,with no significant difference（P〉0.05）.In Groups A and C,the SOD value was declined,with no significant difference（P〉0.05）,the MDA value was gradually declined,with a significant difference（P〈0.05） and the BUN,Cr values showed no obvious change.There was no significant difference in the SOD and MDA values as well as the BUN and Cr values between Groups A and Group C（P〉0.05）.There was a significant difference in the SOD and MDA values（P〈0.05） and there was no significant difference in the BUN and Cr values（P〉0.05） between Group A and Group B as well as between Group B and Group C.Conclusion：（1） Sevoflurane produces free radicals,with potential and mild renal toxicity.（2） Clinical anesthesia doses of propofol can effectively eliminate free radicals,which has a significant protective effect on kidney damage from sevoflurane.（3）Combined anesthesia of sevoflurane with propofol is an ideal method.
出处
《黑龙江医药科学》
2011年第1期16-17,共2页
Heilongjiang Medicine and Pharmacy
