地氟醚、七氟醚和异氟醚对猪肝血流及肝氧供需平衡的影响  

Effects of desflurane, sevoflurane and isoflurane on hepatic blood flow and hepatic oxygen delivery and consumption in swine

作　　者：郁勤燕[1] 王祥瑞[1] 杭燕南[1] 马曙亮[1] 张晓庆[1] 孙大金[1] 

机构地区：[1]上海第二医科大学附属仁济医院麻醉科,200001

出　　处：《中华麻醉学杂志》2000年第10期624-627,共4页Chinese Journal of Anesthesiology

摘　　要：目的　观察不同浓度地氟醚、七氟醚和异氟醚对肝脏氧供需平衡和肝脏血供的影响。方法　杂种猪 15只 ,随机分为 3组 :A为地氟醚组 (n =5 ) ,B为七氟醚组 (n =5 ) ,C为异氟醚组 (n =5 )。采用连续温度稀释法心排血量监测仪和超声多普勒血流量测定仪观察不同浓度地氟醚、七氟醚和异氟醚对猪全身及肝脏的血流和氧供需平衡的影响。结果　① 3组药物均使总肝血流剂量依赖性下降 ;地氟醚和异氟醚对总肝血流的影响与心排血量 (CO)相似 ,七氟醚对总肝血流的影响大于CO ;② 3种吸入麻醉药不同程度降低全身和肝脏氧供 ,吸入 1 0MAC ,机体能保持全身及肝氧耗恒定。结论　地氟醚、七氟醚和异氟醚均显著降低肝氧供 ,1 0MAC时仍能保持肝氧耗恒定 ,对肝细胞内呼吸和代谢的影响不大。Objective To observe the effects of desflurane, sevoflurane and isoflurane on hepatic oxygen balance and hepatic blood flow Methods Fifteen pigs were randomly divided into three groups: A desflurane group(n=5), B sevoflurane group(n=5), C isoflurane group(n=5) This study observed the effects of desflurane, sevoflurane and isoflurane on systemic and hepatic blood flow and oxygen balance with different concentrations using continuous thermodilution cardiac output monitor and ultrasonic Doppler blood flow monitorResults ①Hepatic blood flow: total hepatic blood flow(THBF) decreased dose-dependently in three groups without significant differences between groups The effects of desflurnae and sevoflurane on THBF were same as those on cardiac output(CO), while the effect of sevoflurane on THBF was larger than that on CO ②Oxygen balance: both systemic oxygen delivery(DO_2) and hepatic oxygen delivery(HDO_2) decreased significantly with the increasing of inhalation concentrations, systemic oxygen delivery(VO_2) and hepatic oxygen consumption(HVO_2) decreased significantly only at high concentration The effects of desflurnae and sevoflurane on HVO_2 and HDO_2 were same as those on VO_2 and DO_2, while the effect of sevoflurane on HDO_2 was larger than that on DO_2, but the effect of sevoflurane on HVO_2 was still same as that on VO_2Conclusions Because of the dose-dependently decreased hepatic blood flow, hepatic oxygen delivery decreases significantly, but hepatic oxygen consumption can be maintained well by self-regulation of hepatic oxygen extraction ratio,indicating that there is almost no influence on hepatic intracellular respiration and metabolism

关 键 词：吸入性麻醉药 肝血流 氧消耗 麻醉药 氧供需平衡 

分 类 号：R971.2[医药卫生—药品] R614[医药卫生—药学]