丙泊酚与地氟醚麻醉对肝癌肝部分切除术后患者肝功能的对比研究  

Comparative Study of Propofol and Desflurane Anesthesia on Liver Function in Patients after Partial Hepatectomy for Hepatocellular Carcinoma

作　　者：宗立武 岳宜峰 解立俊[1] ZONG Liwu;YUE Yifeng;XIE Lijun(Department of Anesthesiology,Zibo Central Hospital,Zibo,Shandong Province,255000 China)

机构地区：[1]淄博市中心医院麻醉科,山东淄博255000

出　　处：《中外医疗》2023年第3期126-130,共5页China & Foreign Medical Treatment

摘　　要：目的比较肝癌肝部分切除术后患者采用丙泊酚与地氟醚麻醉对肝功能的影响。方法随机选取2021年2月—2022年2月在淄博市中心医院行肝癌肝部分切除术的患者100例为研究对象,根据随机数表法分成研究组(n=50)与对照组(n=50),对照组采用地氟醚进行麻醉,研究组采用丙泊酚进行麻醉,对两组麻醉效果、肝功能、认知功能及不良反应进行比较。结果研究组苏醒时间、拔管时间、自主呼吸恢复时间较对照组明显更短、平均脉动压较对照组明显更高,差异有统计学意义(P<0.05);麻醉后24 h,两组血浆门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBil)明显增高,但研究组较对照组明显更低,差异有统计学意义(P<0.05);术后3 d,两组语言能力、定向力、记忆力明显降低,研究组较对照组明显更高,差异有统计学意义(P<0.05);研究组不良反应发生率(4.00%)与对照组(8.00%)比较,差异无统计学意义(χ^(2)=0.177,P>0.05)。结论与地氟醚相比,肝癌肝部分切除术后患者采用丙泊酚进行麻醉可明显提高麻醉效果,安全性较高,且对肝功能及认知功能的影响较小。Objective To compare the effects of propofol and desflurane anesthesia on liver function in patients after partial hepatectomy for hepatocellular carcinoma.Methods 100 patients who underwent partial hepatectomy for liver cancer at Zibo Central Hospital from February 2021 to February 2022 were randomly selected as the study subjects.They were randomly divided into a study group(n=50)and a control group(n=50)using a random number table method.The control group was anesthetized with desflurane,while the study group was anesthetized with propofol.The anesthesia effects,liver function,cognitive function,and adverse reactions of the two groups were compared.Results The recovery time,extubation time,and spontaneous breathing recovery time of the study group were significantly shorter than those of the control group,and the average pulse pressure was significantly higher than that of the control group,the difference was statistically significant(P<0.05);after 24 h of anesthesia,the levels of plasma aspartate aminotransferase(AST),alanine aminotransferase(ALT),and total bilirubin(TBil)in the two groups were significantly increased,but the study group was significantly lower than the control group,the difference was statistically significant(P<0.05);after 3 d of surgery,the language ability,directional ability,and memory of the two groups were significantly reduced,and the research group was significantly higher than the control group,the difference was statistically significant(P<0.05);there was no statistically significant difference in the incidence of adverse reactions between the study group(4.00%)and the control group(8.00%)(χ^(2)=0.177,P>0.05).Conclusion Compared with desflurane,anesthesia with propofol in patients after partial hepatectomy for hepatocellular carcinoma can significantly improve the anesthetic effect with higher safety and less impact on liver function and cognitive function.

关 键 词：丙泊酚 地氟醚 肝癌 肝部分切除术 肝功能 

分 类 号：R614[医药卫生—麻醉学]