比较硬膜外阻滞复合安氟醚或异氟醚对肝血流及氧代谢的影响  

The effects of epidural block combined with enflurane or isoflurane inhalation on hepatic blood flow and oxygen metabolism

作　　者：李士通[1] 庄心良[1] 徐国辉[1] 陆惟俊[1] 陈武荣[1] 

机构地区：[1]上海市第一人民医院麻醉科,200080

出　　处：《中华麻醉学杂志》1999年第4期239-241,共3页Chinese Journal of Anesthesiology

摘　　要：目的　探讨硬膜外阻滞与安氟醚或异氟醚吸入复合麻醉对血流动力学、肝血流及氧代谢的影响。方法　选用健康杂种犬２０ 只行胸段硬膜外阻滞后均分为两组，分别吸入０５ 和１０ＭＡＣ安氟醚或异氟醚，监测麻醉前后体循环、肝动脉、门静脉血流动力学及肝脏氧供、氧耗。结果　硬膜外阻滞后血压、门静脉血流和氧供下降。加吸安氟醚０５ＭＡＣ使心排血量也下降，１０ＭＡＣ后肝动脉血流及氧供也减少。加吸异氟醚０５ＭＡＣ心排血量稳定，１０ＭＡＣ后肝动脉血流及氧供与麻醉前比较仍无统计学差异。两组硬膜外阻滞复合吸入麻醉后心率、血压、门静脉血流和氧供、肝氧耗下降程度相近。Objective To explore the effects of epidural block combined with enflurane or isoflurane inhalation on hemodynamics and hepatic blood flow and oxygen delivery and consumption Methods Systemic and hepatic hemodynamics,oxygen delivery and consumption were studied in 20 healthy mongrel dogs anesthetized with epidural block combined with 0 5 or 1 0 MAC of either enflurane (n=10) or isoflurane (n=10) inhalation Results MAP,portal vein blood flow and oxygen delivery decreased significantly after epidural block Combined with 0 5 MAC enflurane CO decreased,with 1 0 MAC enflurane hepatic artery blood flow and oxygen delivery decreased too CO was not changed significantly by combined epidural block with 0 5 MAC isoflurane,and hepatic artery blood flow and oxygen delivery did not decrease significantly after 1 0 MAC isoflurane combined with epidural block The changes of HR,MAP,portal vein blood flow and oxygen delivery,hepatic oxygen consumption were similar in two groups Conclusion Epidural block combined with isoflurane inhalation causes less significant disturbance of systemic and hepatic hemodynamics and oxygen delivery than combined with enflurane

关 键 词：肝 血流动力学 硬膜外麻醉 恩氟烷 异氟烷 

分 类 号：R614.42[医药卫生—麻醉学]