摘要
目的探讨七氟醚复合丙泊酚对肝硬化患者术后免疫功能、肝肾功能的影响。方法选取2016年8月~2019年7月期间首都医科大学附属北京朝阳医院西区收治的102例拟行脾切断流术的肝硬化患者,依据随机数字表法分为研究组(n=51,七氟醚复合丙泊酚麻醉)和对照组(n=51,七氟醚麻醉),记录并比较两组患者自主呼吸恢复时间、定向力恢复时间、言语应答时间、睁眼时间和拔管时间,CD3^+、CD4^+、CD8^+、CD4^+/CD8^+,谷氨酸氨基转移酶(ALT)、总胆红素(TBil),尿素氮(BUN)、肌酐(Cr)及不良反应发生情况。结果两组术前CD3^+、CD4^+/CD8^+、CD8^+、CD4^+比较,差异无统计学意义(P>0.05);两组术后第3天CD3^+、CD4^+/CD8^+、CD4^+低于术前,且研究组高于对照组,差异均有统计学意义(均P<0.05);CD8^+高于术前,且研究组低于对照组,差异均有统计学意义(均P<0.05)。研究组自主呼吸恢复时间、定向力恢复时间、言语应答时间、睁眼时间、拔管时间均短于对照组,差异均有统计学意义(均P<0.05)。两组术前血清ALT、TBil、BUN、Cr水平比较,差异无统计学意义(P>0.05);两组术后第3天血清ALT、TBil、BUN和Cr水平均高于术前,且研究组低于对照组,差异均有统计学意义(均P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论肝硬化患者术中麻醉选用七氟醚复合丙泊酚,可有效改善围术期指标,减少肝肾功能损害,减轻免疫抑制,且用药安全性较好,具有较高的临床应用价值。
Objective To investigate the effect of Sevoflurane combined with Propofol on immune function and liver and kidney function in patients with liver cirrhosis after operation.Methods From August 2016 to July 2019,102 patients with liver cirrhosis who were to undergo splenectomy in West District of Beijing Chaoyang Hospital,Capital Medical University were selected.The patients were randomly divided into study group(n=51,Sevoflurane combined with Propofol anesthesia)and control group(n=51,Sevoflurane anesthesia)according to the randorm number table method.The recovery time of spontaneous respiration,orientation,speech response,eye opening and extubation,CD3^+,CD4^+,CD8^+,CD4^+/CD8^+,glutamate amino transferase(ALT),total bilirubin(TBil),blood urea nitrogen(BUN),creatinine(CR)and adverse reactions were recorded and compared between the two groups.Results There was no significant difference in preoperative CD3^+,CD4^+/CD8^+,CD8^+and CD4^+between the two groups(P>0.05).In the third day after operation,CD3^+,CD4^+/CD8^+and CD4^+in both groups were lower than those before operation,and study group was higher than control group,the differences were statistically significant(all P<0.05);CD8^+was higher than that before operation,and study group was lower than control group,the differences were statistically significant(all P<0.05).The recovery time of spontaneous respiration,orientation,speech response,eye opening and extubation in study group were shorter than those in control group,the differences were statistically significant(all P<0.05).There were no significant differences in serum levels of ALT,TBil,BUN and Cr between the two groups(P>0.05).The serum levels of ALT,TBil,BUN and Cr in study group were higher than those in control group on the third day after operation,study group was lower than control group,the differences were statistically significant(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Sevoflurane combined with Propofol can effectively improve the perioperative indexes,reduce the damage of liver and kidney function,reduce the immunosuppression,and the drug safety is good,which has high clinical application value.
作者
张坤
柯山
ZHANG Kun;KE Shan(Department of Anesthesiology,West District of Beijing Chaoyang Hospital,Capital Medical University,Beijing100043,China;Department of Hepatobiliary,West District of Beijing Chaoyang Hospital,Capital Medical University,Beijing100043,China)
出处
《中国医药导报》
CAS
2020年第7期111-114,119,共5页
China Medical Herald
基金
北京市医院管理局市属医院科研培育计划西医立项(PX2017014)
吴阶平医学基金会临床科研专项资助基金项目(320.6750.15275)。
关键词
七氟醚
丙泊酚
肝硬化
术后
免疫功能
肝肾功能
Sevoflurane
Propofol
Liver cirrhosis
Postoperative
Immune function
Liver and kidney function
