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异氟烷与七氟烷对肝移植患者心肌保护作用的对比观察
作者:段霞光 何志强 郝天兵 刘慧 康于庆 
单位:内蒙古医科大学第三附属医院麻醉科 内蒙古 包头 014010 
关键词:关键词:异氟烷 七氟烷 肝移植 心肌保护 
分类号:中图分类号:R 614文献标志码:A文章编号:1005-5495(
出版年,卷(期):页码:2013,30(3):253-254
摘要:
摘要:目的观察对比异氟烷与七氟烷对肝移植患者心肌的保护作用。方法随机将26例行原位肝移植的患者分为异氟烷组和七氟烷组各13例;术中,异氟烷组采用异丙酚TCI与异氟烷1MAC麻醉维持、七氟烷组采用异丙酚TCI与七氟烷1MAC麻醉维持;检测两组患者在术前、麻醉后、无肝前期、无肝期、新肝期、术毕12 h等6个时相血浆CK、CK\|MB及cTnI的浓度。结果七氟烷组患者血浆CK、CK\|MB及cTnI浓度在无肝前期、无肝期、新肝期及术毕12 h等时相均显著低于异氟烷组,差异有统计学意义(P<0.05)。结论七氟烷对肝移植术患者心肌有保护作用。
Department of Anesthesiology,the Third Affiliated Hospital of Inner Mongolia Medical University,Baotou 014010,China
Abstract:ObjectiveMyocardial protection in the liver transplant patients with isoflurane and sevoflurane were compared.MethodsTwenty\|six cases of orthotopic liver transplant patients were randomly divided into the isoflurane group and sevoflurane group,13 cases in each group.During surgery,the cases in the isoflurane group were adopted TCI of propofol and 1MAC isoflurane to anesthesia,and propofol TCI and the sevoflurane 1MAC were used to maintain anesthesia in the sevoflurane group.The plasma CK,CK\|MB and cTnI activity were measured in all patients at six\|phase of before surgery,after anesthesia,before anhepatic phase,anhepatic phase,new liver and 12 hours after surgery.ResultsThe plasma CK,CK\|MB and cTnI concentrations in 4 phases of before anhepatic phase,anhepatic phase,new liver and the 12 hours after surgery in the sevoflurane group were significantly lower (P<0.05) than that in the Isoflurane group.ConclusionSevoflurane has myocardial protection in patients with liver transplantation.
基金项目:
作者简介:
参考文献:
\[1\]Zamirian M,Tavassoli M,Aghasadeghi K.Corrected QT interval and QT dispersion in cirrhotic patients before and after liver transplantation\[J\].Arch Iran Med,2012,15(6):375.
\[2\]Lentine KL,Costa SP,Weir MR,et al.Cardiac disease evaluation and management among kidney and liver transplantation candidates:a scientific statement from the American Heart Association and the American College of Cardiology Foundation\[J\].J Am Coll Cardiol,2012,60(5):434.
\[3\]Xu ZD,Xu HT,Yuan HB,et al.Postreperfusion syndrome during orthotopic liver transplantation:a single\|center experience\[J\].Hepatobiliary Pancreat Dis Int,2012,11(1):34\|39.
\[4\]Leithead JA,Tariciotti L,Gunson B,et al.Donation after cardiac death liver transplant recipients have an increased frequency of acute kidney injury\[J\].Am J Transplant,2012,12(4):965\|975.
\[5\]Giakoustidis A,Cherian TP,Antoniadis N,et al.Combined cardiac surgery and liver transplantation:three decades of worldwide results\[J\].J Gastrointestin Liver Dis,2011,20(4):415\|421.
\[6\]吴东进,徐益萍,吴蔚宇,等.七氟烷吸入诱导与静脉诱导麻醉在心脏手术患儿中的比较\[J\].上海医学,2010,33(6):521\|524.
\[7\]Crystal GJ,Malik G,Yoon SH,et al.Isoflurane late preconditioning against myocardial stunning is associated with enhanced antioxidant defenses\[J\].Acta Anaesthesiol Scand,2012,56(1):39\|47.
\[8\]Bignami E,Greco T,Barile L,et al.The effect of isoflurane on survival and myocardial infarction:a meta\|analysis of randomized controlled studies\[J\].J Cardiothorac Vasc Anesth,2013,27(1):50\|58.
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