中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2012年
5期
545-547
,共3页
甘露醇%肝切除术%醛还原酶%红细胞%一氧化氮%丙二醛
甘露醇%肝切除術%醛還原酶%紅細胞%一氧化氮%丙二醛
감로순%간절제술%철환원매%홍세포%일양화담%병이철
Mannitol%Hepatectomy%Aldehyde reductase%Erythrocytes%Nitric oxide%Malondialdehyde
目的 探讨甘露醇对肝叶切除术患者红细胞醛糖还原酶(AR)活性、血浆一氧化氮(NO)和丙二醛(MDA)浓度的影响.方法 择期行肝叶切除术患者40例,性别不限,年龄24～60岁,体重50～ 68 kg,ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将其随机分为2组(n=20):生理盐水对照组(C组)和甘露醇组(M组).2组均采用硬膜外复合全麻.术中阻断肝门即刻开始静脉输注20％甘露醇1.5 ml/kg,经30 min输完,C组给予等容量生理盐水.分别于麻醉前(基础状态)、肝门开放前即刻、术毕、术后1d、术后3 d(T0-4)时采集静脉血样,测定红细胞AR活性、血浆NO和MDA浓度.结果 与C组比较,M组T1.2时AR活性及血浆MDA浓度降低,血浆NO浓度升高(P＜0.05).结论 甘露醇可降低肝叶切除术患者肝缺血再灌注损伤,其机制与清除氧自由基,抑制脂质过氧化反应有关.
目的 探討甘露醇對肝葉切除術患者紅細胞醛糖還原酶(AR)活性、血漿一氧化氮(NO)和丙二醛(MDA)濃度的影響.方法 擇期行肝葉切除術患者40例,性彆不限,年齡24～60歲,體重50～ 68 kg,ASA分級Ⅰ或Ⅱ級,採用隨機數字錶法,將其隨機分為2組(n=20):生理鹽水對照組(C組)和甘露醇組(M組).2組均採用硬膜外複閤全痳.術中阻斷肝門即刻開始靜脈輸註20％甘露醇1.5 ml/kg,經30 min輸完,C組給予等容量生理鹽水.分彆于痳醉前(基礎狀態)、肝門開放前即刻、術畢、術後1d、術後3 d(T0-4)時採集靜脈血樣,測定紅細胞AR活性、血漿NO和MDA濃度.結果 與C組比較,M組T1.2時AR活性及血漿MDA濃度降低,血漿NO濃度升高(P＜0.05).結論 甘露醇可降低肝葉切除術患者肝缺血再灌註損傷,其機製與清除氧自由基,抑製脂質過氧化反應有關.
목적 탐토감로순대간협절제술환자홍세포철당환원매(AR)활성、혈장일양화담(NO)화병이철(MDA)농도적영향.방법 택기행간협절제술환자40례,성별불한,년령24～60세,체중50～ 68 kg,ASA분급Ⅰ혹Ⅱ급,채용수궤수자표법,장기수궤분위2조(n=20):생리염수대조조(C조)화감로순조(M조).2조균채용경막외복합전마.술중조단간문즉각개시정맥수주20％감로순1.5 ml/kg,경30 min수완,C조급여등용량생리염수.분별우마취전(기출상태)、간문개방전즉각、술필、술후1d、술후3 d(T0-4)시채집정맥혈양,측정홍세포AR활성、혈장NO화MDA농도.결과 여C조비교,M조T1.2시AR활성급혈장MDA농도강저,혈장NO농도승고(P＜0.05).결론 감로순가강저간협절제술환자간결혈재관주손상,기궤제여청제양자유기,억제지질과양화반응유관.
Objective To investigate the effects of mannitol on the activity of erythrncyte aldose reduclase (AR),plasma nitric oxide(NO)and malondialdehyde(MDA)concentrations in patients undergoing hepatolobectomy.Methods Forty ASA Ⅰ or Ⅱ patients(aged 24-63 yr and weighing 50-68 kg),receiving combined general and epidural anesthesia and undergoing selective hepatolobectomy,were randomly assigned into a mannitol group (group M)and a normal saline group(group C).During hepatic portal occlusion,normal saline 1.5 ml/kg and 20％ mannitol 1.5 ml/kg were intravenously infused in groups C and M respectively for 30 min.Venous blood samples were collected to measure the erythrocyte AR activity and plasma NO and MDA concentrations at the following time points:before anesthesia induction(T0),at the end of hepatic portal occlusion(T1),at the end of operation(T2),one day after operation(T3)and three days after operation(T4),respectively.Results Compared with group C at T1,2,the erythrocyte AR and plasma MDA concentration decreased while plasma NO concentration increased in group M(P ＜ 0.05).Conclusion Mannitol can reduce hepatic ischemia and reperfusion injury in patients undergoing hepatolobectomy,which may be related to the mechanism of mannitol removing oxygenderived free radicals and inhibiting lipid peroxidation.
