摘要
目的探讨七氟醚静吸复合麻醉对肝炎肝硬化手术患者肝功能、肾功能及细胞免疫功能的影响。方法选择2014年3月至2015年3月医院择期行手术治疗的肝炎肝硬化患者62例随机分为观察组31例和对照组31例。2组患者术前24h停用各类药物，人室后开放外周静脉，常规检测血氧饱和度、血压、脑电图、心电图，麻醉前肌注苯巴比妥钠、阿托品。观察组采用静吸复合麻醉，麻醉诱导：静脉注射芬太尼3μg，依托咪酯注射液0．2mglkg，咪达唑仑注射液0．05mg／kg，注射用顺苯磺阿曲库铵0．2mg／kg；麻醉维持：吸入3％七氟醚，持续泵人注射用顺苯磺阿曲库铵0．2mg／（kg·h），注射用盐酸瑞芬太尼0．2μg/kg·h）。对照组采用全凭静脉麻醉，麻醉诱导时丙泊酚注射液2mg／kg代替依托咪酯注射液，麻醉维持持续泵人丙泊酚注射液5mg／（kg·h）代替七氟醚，其他麻醉药物同观察组。比较2组患者麻醉前（t1）、诱导后2h（t2）、术后1d（t3）时段肝肾功能、细胞免疫功能情况，并记录术后24h不良反应发生情况。结果2组患者t2时ALT、Scr、BUN显著高于t1时，ALB、CD4^＋、CD4^＋／CD8^＋、NK明显低于t．时（P〈0．05），但观察组变化幅度明显小于对照组（P〈0．05）；2组患者术后24h内发生呼吸抑制、头晕头痛、恶心呕吐、咽喉疼痛、肌颤、嗜睡、咳嗽无力不良反应发生情况比较，差异无统计学意义（P〉0．05）。结论七氟醚静吸复合麻醉对肝炎肝硬化患者手术肝肾功能、细胞免疫功能影响较小，有利于免疫功能恢复，安全可靠，值得临床推广应用。
Objective To investigate the effect of sevoflurane intravenous-inhalation combined anesthesia on liver function, renal function, and cellular immune function in surgical patients with hepatitis cirrhosis. Methods 62 surgical patients with hepatitis cirrhosis treated in our hospital from March 2014 to March 2015 were selected and randomly divided into observation group （31 cases） and control group （31 cases）. Within 24 hours before surgery, various types of drugs of the two groups disabled, opening the peripheral vein after into the operating room, routine testing of oxygen saturation, blood pressure, electroencephalogram, electrocardiogram, intramuscular injection of phenobarbital sodium and atropine before anesthesia. The observation group was treated with intravenous-inhalation combined anesthesia [anesthesia induction： intravenous injection of fentanyl 3μg, etomidate injection 0.2 mg/kg, midazolam injection 0.05 mg/kg, cis-atracurium 0.2 mg/kg; anesthesia 1 maintenance： inhalation of 3% sevoflurane, continuous injection of paracetampl atracurium 0.2 mg/（kg.h）, 1 remifentanil 0.2μg/（kg h）], while the control group was treated with total intrayenous anesthesia [anesthesia induction： propofol 2 mg/kg instead of etomidate, anesthesia maintenance： continuous injection of propofol injection 5 mg/（kgoh） instead of sevoflurane, other narcotic drugs with the observation group]. Compared liver function, renal function, and cellular immune function of two groups before anesthesia （t1）, 2 h after induction （t2）, 1 d after operation （t3）, recorded the adverse reactions that occurred within 24 hours after operation. Results In two groups, the levels ofALT, Scr, and BUN at t2 were significantly higher than those at tl （P〈0.05）, the levels ofALB, CD4^＋, CD4^＋/CD8^＋, NK att： were significantly lower than those at t1 （P〈0.05）, but the change range of observation group was significantly less than that of control group （P〈0.05）. There were no statistically sign
出处
《国际医药卫生导报》
2017年第12期1910-1914,共5页
International Medicine and Health Guidance News
关键词
七氟醚
静吸复合麻醉
肝炎肝硬化
肝肾功能
免疫功能
Sevoflurane
Intravenous-inhalation combined anesthesia
Hepatitis cirrhosis
Liver and renal function
Immune function
