七氟烷吸入麻醉对腹部手术患者血清肌钙蛋白I的影响  

Effects of sevoflurane inhalational anesthesia on serum cardiac troponin I in patients undergoing abdominal surgery

作　　者：申雪花[1] 韩伟[1] 王金[1] 麻海春[1] 

机构地区：[1]吉林大学第一医院麻醉科,吉林长春130021

出　　处：《吉林大学学报（医学版）》2009年第3期539-542,共4页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅科研基金资助课题(200505225)

摘　　要：目的：研究七氟烷吸入麻醉对腹部手术患者围术期血流动力学及血清肌钙蛋白I（cTnI）的影响，为临床麻醉用药的选择提供参考。方法：选择ASAⅡ～Ⅲ级、择期行胃癌根治术的患者40例，随机分为七氟烷组（S组）和丙泊酚组（P组），每组20例。常规监测收缩压（SBP）、舒张压（DBP）、心率（HR）、血氧饱和度（SPO2），分别于麻醉前（T1）、诱导后（T2）、手术开始时（T3）、术毕后（T4）、术后1d（1）和术后3d（Ts）6个时间点采静脉血5mL，以放射免疫法测定血清cTnI的含量。结果：两组诱导后SBP、DBP及HR均有所下降，与麻醉前比较，P组诱导后下降较显著（P〈0．05），组间同一时间点比较差异也有显著性（P〈0．05）；两组患者麻醉诱导后cTnI含量均有升高趋势，P组在诱导后及术后1dcTnI含量显著升高，与麻醉前及S组同一时间点比较差异有显著性（P〈0．05）。结论：七氟烷吸入麻醉诱导期血流动力学相对平稳，与丙泊酚组比较围术期心肌损伤较轻，提示七氟烷吸入麻醉对围术期心肌保护作用强于丙泊酚。Objective To discuss the effects of sevoflurane on perioperative hemodynamics and serum cardiac troponin I （cTnI） in patients undergoing abdominal surgery, and offer the reference for selecting anesthetic in clinic. Methods Forty patients with ASA Ⅱ -Ⅲ, undergoing radical gastrectomy were randomly allocated into sevoflurane group （group S） and propofol group （group P）, with each 20 patients. Systemic blood pressure （SBP）, diastolic blood pressure （DBP）, heart teat （HR） and saturation of oxygen （SPO2） were monitored as routine. The concerntration of cTnI was examined at pre-anesthesia （T1）, post-induction （T2）, beginning of operation （T3）, end of operation （T4）, the first day post-operation （Ts） and the third day post-operation （T6） with radioimmunoassay. Results SBP, DBP and HR in group P at post-induction were significantly lower than those in group S （P〈0.05）. The concerntration of cTnI in group P was significantly higher than that in group S at post-induction and the first day post-operation （P〈0.05）. Conclusion Hemodynamics in sevoflurane group keeps steady during the induction period, and shows lighter myocardial injury compared with propofol group, the result indicates that perioperative myocardial protection of sevoflurane is better than that of propofol.

关 键 词：七氟烷 麻醉 吸入 丙泊酚 肌钙蛋白 

分 类 号：R614.21[医药卫生—麻醉学]