摘要
目的观察七氟烷吸入溶液剂用于高海拔地区藏族肝包虫手术患者的临床疗效及安全性。方法将89例拟进行肝包虫手术的高海拔地区藏族患者随机分为对照组43例和试验组46例。对照组给予咪达唑仑2 mg+0.15 mg·kg^(-1)顺式阿曲库铵+2 mg·kg^(-1)丙泊酚+舒芬太尼20~30μg进行麻醉诱导,术中给予瑞芬太尼和丙泊酚分别以25~150μg·kg^(-1)·min^(-1)和0.01~0.10μg·kg^(-1)·min^(-1)的速度静脉麻醉维持,并视术中情况追加顺式阿曲库铵。试验组在麻醉诱导时联合吸入30%七氟烷30 min,其余治疗方法同对照组。比较2组患者的谷丙转氨酶(GPT)和谷草转氨酶(GOT)水平,以及药物不良反应的发生情况。结果在阻断肝门后10 min、恢复肝血流20 min、恢复肝血流1 h和术后12 h时,试验组的GPT分别为(89.82±21.19),(120.01±30.02),(153.21±44.39)和(230.02±56.28)U·L^(-1),GOT分别为(78.82±19.20),(115.50±33.40),(162.20±50.03)和(204.03±60.38)U·L^(-1);对照组的GPT分别为(102.29±25.59),(167.28±29.89),(230.11±52.31)和(365.21±66.54)U·L^(-1),GOT分别为(101.10±23.30),(153.32±35.50),(210.15±49.82)和(290.88±59.82)U·L^(-1)。2组患者相同时间点的上述指标比较,差异均有统计学意义(均P<0.05)。试验组术后出现的药物不良反应有咳嗽和恶心呕吐,对照组术后出现的药物不良反应有恶心呕吐、咳嗽和头痛。试验组和对照组的总药物不良反应发生率分别为17.39%和16.28%,差异无统计学意义(P>0.05)。结论七氟烷吸入溶液剂用于高海拔地区藏族患者肝包虫手术患者具有肝保护作用,且不增加药物不良反应的发生率。
Objective To observe the clinical efficacy and safety of sevoflurane inhalation solution in the treatment of hepatic echinococcosis in Tibetan patients at high altitude.Methods A total of 89 Tibetan patients with hydatidosis at high altitude were randomly divided into control group(n=43 cases)and treatment group(n=46 cases).The control group was anesthetized with midazolam 2 mg+0.15 mg·kg^(-1)cisatracurium+2 mg·kg^(-1)propofol+sufentanil 20-30μg;remifentanil and propofol were given intravenous anesthesia at the rate of 25-150μg·kg^(-1)·min^(-1) and 0.01-0.10μg·kg^(-1)·min^(-1),respectively,and cisatracurium was added according to the intraoperative condition.The treatment group was combined with inhalation of 30%sevoflurane for 30 min,during anesthesia induction and other treatments were the same as those in the control group.The levels of glutamic-pyruvic transaminase(GPT)and glutamic oxaloacetic transaminase(GOT),and adverse drug reactions were compared between two groups.Results At the 10 minutes after hepatic portal occlusion,20 minutes after hepatic blood flow recovery,1 hour after liver blood flow recovery and 12 hours after operation,the GPT in treatment group were(89.82±21.19),(120.01±30.02),(153.21±44.39)and(230.02±56.28)U·L^(-1),the GOT were(78.82±19.20),(115.50±33.40),(162.20±50.03)and(204.03±60.38)U·L^(-1);the GPT in control group were(102.29±25.59),(167.28±29.89),(230.11±52.31)and(365.21±66.54)U·L^(-1),the GOT were(101.10±23.30),(153.32±35.50),(210.15±49.82)and(290.88±59.82)U·L^(-1).There were significant differences in the above-mentioned indexes at the same time point between the two groups(all P<0.05).The postoperative adverse drug reactions in the treatment group were cough and nausea and vomiting,while those in the control group were nausea and vomiting,cough and headache.The incidences of total adverse drug reactions in the treatment and control groups were 17.39%and 16.28%without significant difference(P>0.05).Conclusion Sevoflurane inhalation solution has a liver
作者
吕志坚
贾珍
刘磊
吴灿
周虎
Lü Zhi-jian;JIA Zhen;LIU Lei;WU Can;ZHOU Hu(Department of Anesthesiology,Qinghai University Affiliated Hospital,Xining 810001,Qinghai Province,China;Department of Hepatobiliary Pancreas,Qinghai University Affiliated Hospital,Xining 810001,Qinghai Province,China)
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2021年第3期234-237,共4页
The Chinese Journal of Clinical Pharmacology
基金
青海省基础研究计划课题资助项目(2017-ZJ-758)。
关键词
七氟烷吸入溶液剂
肝包虫
藏族
高海拔地区
安全性评价
sevoflurane inhalation solution
hepatic hydatid
Tibetan
high altitude area
safety evaluation
