七氟醚对肝炎肝硬化患者围术期凝血功能的影响  

Effects of sevoflurane on blood coagulation function in patients with hepatocirrhosis

作　　者：殷国平[1] 张维峰[1] 王佳[1] 廖建梅[1] 张春明[1] 

机构地区：[1]东南大学附属第二医院麻醉科,江苏省210003

出　　处：《江苏医药》2012年第23期2843-2844,共2页Jiangsu Medical Journal

摘　　要：目的观察七氟醚对肝炎肝硬化患者围术期凝血功能的影响。方法择期行脾切除断流手术的肝炎肝硬化患者40例,随机均分为两组,分别采用七氟醚组(S组)和异氟醚组(I组)麻醉。于麻醉诱导前(T0)和手术结束时(T1)2个时点检测部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原浓度(Fib)和血栓弹性描记图(TEG),并记录手术时间及出血量等。结果与T0比较,T1时S组PT增高,Fib降低;与T0比较,I组除PT增高、Fib降低外,APTT也增高(P<0.05)。与T0比较,S组T1时TEG的最大振幅(MA)明显降低[(70.26±7.42)mm vs.(55.19±5.11)mm](P<0.05)。结论与异氟醚相比,七氟醚对肝炎肝硬化患者围术期凝血4项指标和TEG参数无影响。Objective To investigate the effects of sevoflurane on blood coagulation function in the patients with hepatocirrhosis.Methods Forty patients with hepatocirrhosis undergoing liver cancer resection were equally randomized into 2 groups of S（anesthesia with sevoflurane of 1 MAC） and I（anesthesia with isoflurane of 1 MAC）.The venous blood was collected for the measurements of prothrombin time（PT）,thrombin time（TT）,activated partial thromboplastin time（APTT）,fibrinogen（Fib） and thrombelastographic（TEG） test before anesthesia induction（T0） and at the end of operation（T1）.The operative time and blood loss were recorded.Results Compared to T0,PT was higher,Fib was lower,at T1 in group S（P0.05）.Compared to T0,PT and APTT were higher,Fib was lower,at T1 in group I（P0.05）.The MA on TEG was lower at T1 than that at T0 [（55.19±5.11） mm vs.（70.26 7.42） mm]（P0.05）.Conclusion Compared with isoflurane,sevoflurane has less significant effects on blood coagulation in the patients with hepatocirrhosis.

关 键 词：凝血功能 七氟烷 异氟醚 肝硬化 血栓弹性描记图 

分 类 号：R614[医药卫生—麻醉学]