摘要
目的评估吸入不同浓度七氟醚麻醉对肝母细胞瘤(HB)婴幼儿术中肝血流的影响。方法前瞻性连续入组2019年1月至2021年8月于山西省儿童医院行根治切除手术的HB婴幼儿22例,其中男性15例,女性7例,年龄(17±7)月龄。收集同期行超声检查的行疝气、隐睾、鞘膜积液手术的无其他系统疾病的非HB婴幼儿19例,其中男性11例,女性8例,年龄(18±5)月龄。术前及术中吸入不同浓度七氟醚后应用超声仪检测患儿肝血流(HBF)相关指标。对比HB患儿与非HB患儿术前、HB患儿1%七氟醚与2%七氟醚吸入后门静脉血流量(PBF)、肝动脉血流量(HABF)、PBF/HABF和HBF。结果与非HB患儿相比,HB患儿PBF[M(Q_(1),Q_(2))]低[41.9 ml/min(26.8 ml/min,63.1 ml/min)比66.7 ml/min(41.4 ml/min,137.2 ml/min),Z=-2.62,P=0.008]、HABF高[31.2 ml/min(20.4 ml/min,50.3 ml/min)比12.9 ml/min(5.5 ml/min,25.0 ml/min),Z=-3.59,P<0.001]、PBF/HABF低[1.3(1.2,1.4)比6.1(5.0,7.5),Z=-5.68,P<0.001],两组间HBF差异无统计学意义(P>0.05)。与2%七氟醚HB患儿组相比,1%七氟醚组PBF低[41.1 ml/min(25.0 ml/min,62.0 ml/min)比63.0 ml/min(40.5 ml/min,78.3 ml/min),Z=-2.09,P=0.036]、PBF/HABF低[1.3(1.1,1.5)比1.8(1.6,1.9),Z=-4.01,P<0.001],两组间HABF、HBF差异均无统计学意义(均P>0.05)。结论行根治手术后HB婴幼儿吸入相对低浓度的七氟醚即可能通过减少PBF而减少术中HBF。
Objective To evaluate the effect of different concentrations of sevoflurane inhalation anesthesia on hepatic blood flow in children with hepatoblastoma(HB).Methods A total of 22 children who underwent radical resection of HB in Shanxi Children's Hospital from January 2019 to August 2021 were perspectively enrolled,including 15 males and 7 females,with an average age of 17±7 months.There were 19 normal children undergoing ultrasound examination without other systemic diseases who received hernia,cryptorchidism,hydrocele of tunica vaginalis surgery during the same period,including 11 males and 8 females,with an average age of 18±5 months.After inhaling different concentrations of sevoflurane preoperatively and intraoperatively,ultrasound apparatus was used to detect the hepatic blood flow(HBF)in HB children.The portal blood flow(PBF),hepatic artery blood flow(HABF),PBF/HABF and HBF were compared between HB children and non-HB children before operation and after inhalation of 1% sevoflurane,2% sevoflurane.Results Compared with non-HB children,children with HB had lower PBF[41.9 ml/min(26.8 ml/min,63.1 ml/min)vs.66.7 ml/min(41.4 ml/min,137.2 ml/min),Z=-2.62,P=0.008],increased HABF[31.2 ml/min(20.4 ml/min,50.3 ml/min)vs.12.9 ml/min(5.5 ml/min,25.0 ml/min),Z=-3.59,P<0.001],decreased PBF/HABF[1.3(1.2,1.4)vs.6.1(5.0,7.5),Z=-5.68,P<0.001],and the difference in HBF between the both groups was statistically significant(P>0.05).Compared with the 2% sevoflurane HB group,PBF was reduced[41.1 ml/min(25.0 ml/min,62.0 ml/min)vs.63.0 ml/min(40.5 ml/min,78.3 ml/min),Z=-2.09,P=0.036]and PBF/HABF was reduced[1.3(1.1,1.5)vs.1.8(1.6,1.9),Z=-4.01,P<0.001]in the 1%sevoflurane group,and the differences in HABF and HBF were statistically significant(all P>0.05).Conclusion Relatively low concentration of sevoflurane reduces HBF by reducing PBF for HB children after radical surgery.
作者
张瑞嘉
张鑫
崔强强
车鸣
Zhang Ruijia;Zhang Xin;Cui Qiangqiang;Che Ming(Department of Anesthesiology,Shanxi Children's Hospital,Taiyuan 030013,China)
出处
《肿瘤研究与临床》
CAS
2022年第10期759-762,共4页
Cancer Research and Clinic
基金
山西省卫计委青年课题(201601068)。
关键词
肝母细胞瘤
高强度聚焦超声
肝脏血流
吸入麻醉
七氟醚
Hepatoblastoma
High-intensity focused ultrasound
Hepatic blood flow
Inhalation anesthesia
Sevoflurane
