紧闭循环麻醉时七氟醚对病人肝肾功能的影响  

Effects of closed-circuit sevoflurane anesthesia on hepato-renal function

作　　者：周少朋[1] 杨禄坤[1] 肖笑雨[1] 桂西青[1] 谢宝富[1] 

机构地区：[1]中山大学附属第五医院麻醉科,珠海市519000

出　　处：《中华麻醉学杂志》2009年第1期31-33,共3页Chinese Journal of Anesthesiology

摘　　要：目的评价紧闭循环麻醉时七氟醚对病人肝肾功能的影响。方法拟行普外科手术病人40例，ASAⅠ或Ⅱ级，年龄20—60岁，随机分为2组（n=20），麻醉诱导后S1组和S2组分别吸入6％-8％国产或进口七氟醚，新鲜气流量2～4L／min，2～3min后调整新鲜气流量至0．18～0．30L／min，随后维持七氟醚呼气末浓度2．6％-3．5％。于术前、术毕、术后1、2、3和5d时测定血清丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）活性、总胆红素（TB）、肌酐（Cr）、尿素（BUN）、β2-微球蛋白（β2-MG）浓度和尿液β2-MG浓度。结果与术前比较，术毕、术后1、2d时两组尿液β2-MG浓度升高（P〈0．05），术后1～5d血清ALT、AST活性和TB、Cr、BUN和β2-MG浓度差异无统计学意义（P〉0．05）；各指标组间比较差异无统计学意义（P〉0．05）。结论紧闭循环麻醉时七氟醚对病人肝肾功能无明显影响。Objective To assess the bepato-renal function after closed-circuit anesthesia with sevoflurane. Methods Forty ASA Ⅰ or Ⅱ patients aged 20-60 yr undergoing operation lasting more than 120 min under general anesthesia were randomized to receive either domestically-produced sevoflurane （group D, n = 20） or imported sevoflurane （group I, n = 20）. Fresh gas flow was first set at 2-4 L/min for 2-3 min then reduced to 0.18-0.30 L/min. The end-tidal sevoflurane concentration was maintained at 2.6%-3.5%. ECG, BP, HR, SpO2, PET CO2, ispiratory and expiratory O2 and sevoflurane concentrations were continuously monitored during operation. Blood samples were taken from peripheral vein before anesthesia （T0 ,baseline）, at the end of surgery （%） and 1, 2, 3, 5 d after operation （T2-5） for determination of serum alanine transaminase （ALT）, aspartate transaminase （AST） activity, total bilirnbin （ TB ）, ereatinine （Cr）, blood urea nitrogen （ BUN ） and microglobulin （β2-MG） concentrations. Urine specimens were taken for determination of β2-MG concentration at the same time periods. Results There were no significant differences in serum ALT, AST activity, TB, Cr, BUN and β2-MG concentrations before and after operation as well as between the 2 groups. β2-MG concentration in urine was significantly increased at T1-3 as compared with the baseline value at To in beth groups but was not significantly different between the 2 groups. Conclusion Closed-cireuit anesthesia with sevoflurane has no significant adverse effect on hepato-renal function.

关 键 词：麻醉药 吸入 麻醉 闭合循环 肝功能试验 肾功能试验 

分 类 号：R614[医药卫生—麻醉学]