文章摘要

不同浓度七氟醚复合丙泊酚麻醉在肝部分切除术患者中的应用

作者: 1陈慧, 1殷国平, 1邓友明, 1杨晓宇
1 南京市第二医院麻醉科,南京 210003
通讯: 殷国平 Email: Yinguoping0304@163.com
DOI: 10.3978/j.issn.2095-6959.2021.11.011

摘要

目的:评估行肝部分切除术患者实施不同浓度七氟醚复合丙泊酚麻醉的临床效果。方法:将南京市第二医院在2018年5月至2020年5月接收的68例行肝部分切除术患者作为此次评估对象,按照随机数字表法将患者均分为研究组(1.0 MAC七氟醚复合丙泊酚静-吸复合麻醉)与对照组(0.5 MAC七氟醚复合丙泊酚静-吸复合麻醉),每组34例,分析两组术后炎症应激反应程度与肝功能变化情况。结果:手术前两组IL-8、IL-10、TNF-α炎症因子水平的差异无统计学意义(P>0.05);手术后研究组IL-8、TNF-α均低于对照组,IL-10高于对照组,差异有统计学意义(P<0.05)。研究组术后的皮质醇(Cor)、去甲肾上腺素(NE)、肾上腺素(E)等指标明显低于对照组,两组比较,差异有统计学意义(P<0.05)。手术后,研究组ALT水平为(22.08±1.16) U/L,AST水平为(37.08±4.21) U/L,ALP水平为(84.34±3.41) U/L,TBil水平为(14.16±1.22) μmol/L,均显著低于对照组(均P<0.05)。研究组并发症发生率显著高于对照组,差异有统计学意义(P<0.05)。结论:高浓度七氟醚复合丙泊酚静-吸复合麻醉可以有效调节肝部分切除术患者的炎症因子,降低应激水平,改善患者肝功能状况,但其并发症发生率相对较高,临床需结合患者实际状况进行治疗。
关键词: 七氟醚;丙泊酚;炎症因子;应激反应;静-吸复合麻醉;肝部分切除术

Application of sevoflurane combined with propofol anesthesia in patients undergoing partial hepatectomy

Authors: 1CHEN Hui, 1YIN Guoping, 1DENG Youming, 1YANG Xiaoyu
1 Department of Anesthesiology, Nanjing Second Hospital, Nanjing 210003, China

CorrespondingAuthor: YIN Guoping Email: Yinguoping0304@163.com

DOI: 10.3978/j.issn.2095-6959.2021.11.011

Abstract

Objective: To evaluate the clinical effects of sevoflurane combined with propofol anesthesia in patients undergoing partial hepatectomy. Methods: A total of 68 patients with partial hepatectomy received in our hospital from May 2018 to May 2020 were taken as the evaluation object. According to the random number table method, the patients were divided into the study group (1.0 MAC sevoflurane combined with Propofol Intravenous Inhalation Combined Anesthesia) and the control group (0.5 MAC sevoflurane combined with Propofol Intravenous Inhalation Combined anesthesia), with 34 patients in each group. The degree of postoperative inflammatory stress and the changes of liver function were analyzed. Results: There was no significant difference in IL-8, IL-10 and TNF-α levels between the 2 groups before operation (P>0.05). After surgery, IL-8 and TNF-α in the study group were lower than those in the control group, while IL-10 was higher than those in the control group, the differences were statistically significant (P<0.05). Cor, NE, E and other indicators in the study group were significantly lower than those in the control group, and the difference was statistically significant (P<0.05). After surgery, the ALT level of the study group was (22.08±1.16) U/L, the AST level was (37.08±4.21) U/L, the ALP level was (84.34±3.41) U/L, and the TBil level was (14.16±1.22) μmol/L. All the data were significantly lower than those in control group (all P<0.05). The incidence of complications in the study group was significantly higher than that in the control group (P<0.05). Conclusion: High concentration sevoflurane combined with propofol intravenous inhalation combined anesthesia can effectively regulate inflammatory factors, reduce stress level and improve liver function in patients undergoing partial hepatectomy, but the incidence of complications is relatively high. Clinical treatment should be combined with the actual situation of patients.
Keywords: sevoflurane; propofol; inflammatory factors; stress response; combined intravenous-inhalation anesthesia; partial hepatectomy

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