Page 23 - 麻醉与监护论坛2016年第1期

杜小兵 摘要

河北大学附属医院（北院）麻醉科，河 目的:探讨七氟醚静吸复合麻醉对肝叶切除术患者肝肾功能的影响。方法:85例择期行
北保定 071000 开腹肝叶切除术患者随机分为七氟醚组(n=44)和丙泊酚组(n=41)，麻醉诱导：七氟醚组所
有患者吸入8%七氟醚，等意识丧失后，用0.2m g·k g-1顺苯磺酸阿曲库胺和0.4μ g·k g-1舒芬
太尼静脉注射；丙泊酚组所有患者将1～2m g·k g-1丙泊酚、0.2m g·k g-1顺苯磺酸阿曲库胺和
0.4μ g·k g-1舒芬太尼静脉注射。麻醉维持：七氟醚组患者持续吸入2%～3%七氟醚，丙泊酚
组患者将0.5～0.8m g·k g-1·h-1丙泊酚持续静脉输注，维持B I S值在40～60之间。记录两组
患者手术一般情况，分别于麻醉诱导前(T0)、术毕(T1)、术后1d(T2)、3d(T3)和5d(T4)时，检
测两组患者肝肾功能指标。结果:与T0时相比，两组患者T1～4时A L T升高，T1～3时A S T升高，Ｔ
2～4时T B i l和D B i l升高，T2时A L B降低，差异均有统计学意义(P<0.05)；七氟醚组患者Ｔ2～4时
A L T、T B i l和D B i l均低于丙泊酚组，Ｔ2～3时A S T低于丙泊酚组，T2时A L B高于丙泊酚组，差异
均有统计学意义(P<0.05)；与T0时相比，两组患者Ｔ2～4时Cystatin C和24h尿微量白蛋白均升
高，差异均有统计学意义(P<0.05)；七氟醚组患者Ｔ2～4时Cystatin C和24h尿微量白蛋白均
低于丙泊酚组，差异均有统计学意义(P<0.05)。结论 相比于丙泊酚复合麻醉，七氟醚静吸
复合麻醉更有利于减轻肝叶切除术中缺血—再灌注损伤对患者肝肾功能的影响。

关键词：肝叶切除术；七氟醚；丙泊酚；肝肾功能

七氟醚静吸复合麻醉对肝叶切除术患者肝
肾功能的影响

Effect of anesthesia combined with sevoflurane inhalation
on liver and kidney function in patients treated with hepatic
lobectomy

DU Xiao-bing

Department of Anesthesiology,Affiliated Hospital of Hebei University(North Yard),Baoding,Hebei 071000,China

Abstract

Objictive: To investigate the effect of anesthesia combined with sevoflurane inhalation on liver and kidney function in
patients treated with hepatic lobectomy.

Methods: 85 cases treared with elective opening hepatic lobectomy were randomly divided into sevoflurane group
(n=44)and propofol group(n=41).Induction of anesthesia:patients in sevoflurane group inhaled 8% sevoflurane,and then
0.2mg·kg-1 of cis-atracurium sulfonic acid amine and 0.4μg·kg-1 sufentanil were intravenously injected upon consciousness
loss.Patients in propofol group were intravenously injected with 1～2mg·kg-1 propofol,0.2mg·kg-1 of cis-atracurium
sulfonic acid amine and 0.4μg·kg-1 sufentanil.Maintenance of anesthesia:the sevoflurane group continued to inhale 2%～
3% sevoflurane,wile the propofol group were treated with continuous infusion of 0.5～0.8mg·kg-1·h-1 propofol,and the
BIS value was maintained around 40 and 60.

Results: Compared with T0,ALT in the two groups at T1～4 was increased,AST at T1～3 was increased,TBil and
DBil at T2～4 were uncreased,and ALB at T2 was decreased(P<0.05).In the sevoflurane group,ALT,TBil
and DBil at T2～4 were lower than the propofol group,AST at T2～3 were lower than the propofol
group,and ALB at T2 was higher than propofol group(P<0.05).Compared with T0 Cystain C and 24h
urine albumin in the two groups at T2～4 were increased,and the differences were statistically
significant(P<0.05).Cystain C and 24h urine albumin in the sevoflurane group at T2～4 were lower
than the propofol group(P<0.05).

Conclusions: Compared with propofol combined with anesthesia,sevoflurane inhalation with anesthesia was more

efficient to alleviate the effects of ischemic-reperfusion injury caused by hepatic lobectomy on liver and kidney function.

Key Words. hepatic lobectomy;sevoflurane;propofol;liver and kidney function

LaboratoryRaenvdieCwlinanicdalCIMnvEeLsteicgtautrioen 30 FAM 2016 Jan/Feb Vol.23 Issue 1
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