CAJ | 학술논문

目的比较七氟醚和异氟醚对肝硬化患者行肝切除术后肝功能变化的影响.方法将40名年龄为40～70岁的肝硬化(Child-Pugh A级),择期行肝癌肝叶切除术的患者随机分为七氟醚组和异氟醚组.两组患者均以咪唑安定0.1mg/kg体重、舒芬太尼0.4μg/kg体重、哌库溴铵1mg/kg体重诱导,分别予七氟醚或异氟醚辅以舒芬太尼维持麻醉.分别于术前、术后1、3、7d抽取非输液侧上肢静脉血测谷草转氨酶、谷丙转氨酶、总胆红素、碱性磷酸酶、胆碱酯酶、白蛋白、凝血酶原时间和血小板计数.结果两组患者血清谷草转氨酶、谷丙转氨酶和碱性磷酸酶较术前明显升高,术后3d达峰,且其增高值在异氟醚组明显高于七氟醚组;术后无患者出现肝衰竭或肝损伤的临床表现.结论在肝硬化患者的麻醉中,异氟醚对肝功能的影响可能强于七氟醚.
목적 비교칠불미화이불미대간경화환자행간절제술후간공능변화적영향.방법 장40명년령위40～70세적간경화(Child-Pugh A급),택기행간암간협절제술적환자수궤분위칠불미조화이불미조.량조환자균이미서안정0.1mg/kg체중、서분태니0.4μg/kg체중、고고추안1mg/kg체중유도,분별여칠불미혹이불미보이서분태니유지마취.분별우술전、술후1、3、7d추취비수액측상지정맥혈측곡초전안매、곡병전안매、총담홍소、감성린산매、담감지매、백단백、응혈매원시간화혈소판계수.결과 량조환자혈청곡초전안매、곡병전안매화감성린산매교술전명현승고,술후3d체봉,차기증고치재이불미조명현고우칠불미조;술후무환자출현간쇠갈혹간손상적림상표현.결론 재간경화환자적마취중,이불미대간공능적영향가능강우칠불미.
Objective To compare postoperative liver function in patients with liver cirrhosis between sevoflurane and isoflurane anesthesia.Methods Forty cirrhotic patients with Child-Pugh grade A,aged 40 to 60 years,scheduled for liver segmentectomy,were randomly divided into sevoflurane and isoflurane groups.All patients had anesthesia induced with midazolam 0.1 mg/kg and sufentanyl 0.4 μg/kg.For maintenance,sufentanyl,sevoflurane or isoflurane was intermittently and intravenously injected.Aspartate aminotransferase,alanine aminotransferase,total bilirubin,alkaline phosphatase,choline esterase,albumin,prothrombin time and platelet count were measured before and 1,3 and 7 days after surgery.Results Aspartate aminotransferase,alanine aminotransferase and alkaline phosphatase were increased significantly and reached the peaks at 3rd day after surgery in both groups.The increases in these variables were more significant in the isoflurane group than those in sevoflurane group.No patients developed hepatic failure.Conclusion In cirrhotic patients,is eflurane might affent the liver function more than sevoflurane.