中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
21期
14-16
,共3页
胡成侠%张丽%杨玉杰%张素华
鬍成俠%張麗%楊玉傑%張素華
호성협%장려%양옥걸%장소화
骨折%七氟烷%异氟烷%肾功能
骨摺%七氟烷%異氟烷%腎功能
골절%칠불완%이불완%신공능
Fractures%bone%Sevoflurane%Isoflurane%Renal function
目的 探讨七氟烷及异氟烷麻醉对严重骨折术后肾功能的影响.方法 共纳入62例严重骨折需要手术患者,均行全身麻醉.62例患者按随机数字表法分为七氟烷组(31例,麻醉维持给予1.5％～3.0％七氟烷)、异氟烷组(31例,麻醉维持给予1.5％～3.0％异氟烷),两组均静脉持续泵注雷米芬太尼0.1～0.2μg/(kg·min),间断静脉注射阿曲库铵维持麻醉.比较两组术后血肌酐(SCr)、血尿素氮(BUN)的差异,同时比较两组患者术后需要行血液透析治疗的例数.结果 两组术后第1、3、7天SCr、BUN水平均显著低于术前[七氟烷组:(517±187)、(163±110)、(103±99)μ mol/L比(853±220)μmol/L,(17.1±7.8)、(9.5±4.1)、(9.7±3.8)mmol/L比(21.8±9.3)mmol/L;异氟烷组:(539±188)、(136±108)、(101±95)μmol/L比(881±220)μ mol/L,(17.5±7.4)、(9.5±3.5)、(9.8±3.3)mmol/L比(20.0±8.9)mmol/L],差异有统计学意义(P＜0.05).术后各时间点SCr、BUN水平两组间比较差异无统计学意义(P＞0.05).术后7d内七氟烷组有1例(3.2％)患者需要行血液透析治疗,异氟烷组亦有1例(3.2％)患者需要行血液透析治疗,两组比较差异无统计学意义(P＞0.05).结论 对于严重骨折行全身麻醉手术的患者,七氟烷与异氟烷均对肾功能无显著不良影响,因此对于此类患者使用七氟烷行麻醉治疗可行,值得临床推广应用.
目的 探討七氟烷及異氟烷痳醉對嚴重骨摺術後腎功能的影響.方法 共納入62例嚴重骨摺需要手術患者,均行全身痳醉.62例患者按隨機數字錶法分為七氟烷組(31例,痳醉維持給予1.5％～3.0％七氟烷)、異氟烷組(31例,痳醉維持給予1.5％～3.0％異氟烷),兩組均靜脈持續泵註雷米芬太尼0.1～0.2μg/(kg·min),間斷靜脈註射阿麯庫銨維持痳醉.比較兩組術後血肌酐(SCr)、血尿素氮(BUN)的差異,同時比較兩組患者術後需要行血液透析治療的例數.結果 兩組術後第1、3、7天SCr、BUN水平均顯著低于術前[七氟烷組:(517±187)、(163±110)、(103±99)μ mol/L比(853±220)μmol/L,(17.1±7.8)、(9.5±4.1)、(9.7±3.8)mmol/L比(21.8±9.3)mmol/L;異氟烷組:(539±188)、(136±108)、(101±95)μmol/L比(881±220)μ mol/L,(17.5±7.4)、(9.5±3.5)、(9.8±3.3)mmol/L比(20.0±8.9)mmol/L],差異有統計學意義(P＜0.05).術後各時間點SCr、BUN水平兩組間比較差異無統計學意義(P＞0.05).術後7d內七氟烷組有1例(3.2％)患者需要行血液透析治療,異氟烷組亦有1例(3.2％)患者需要行血液透析治療,兩組比較差異無統計學意義(P＞0.05).結論 對于嚴重骨摺行全身痳醉手術的患者,七氟烷與異氟烷均對腎功能無顯著不良影響,因此對于此類患者使用七氟烷行痳醉治療可行,值得臨床推廣應用.
목적 탐토칠불완급이불완마취대엄중골절술후신공능적영향.방법 공납입62례엄중골절수요수술환자,균행전신마취.62례환자안수궤수자표법분위칠불완조(31례,마취유지급여1.5％～3.0％칠불완)、이불완조(31례,마취유지급여1.5％～3.0％이불완),량조균정맥지속빙주뢰미분태니0.1～0.2μg/(kg·min),간단정맥주사아곡고안유지마취.비교량조술후혈기항(SCr)、혈뇨소담(BUN)적차이,동시비교량조환자술후수요행혈액투석치료적례수.결과 량조술후제1、3、7천SCr、BUN수평균현저저우술전[칠불완조:(517±187)、(163±110)、(103±99)μ mol/L비(853±220)μmol/L,(17.1±7.8)、(9.5±4.1)、(9.7±3.8)mmol/L비(21.8±9.3)mmol/L;이불완조:(539±188)、(136±108)、(101±95)μmol/L비(881±220)μ mol/L,(17.5±7.4)、(9.5±3.5)、(9.8±3.3)mmol/L비(20.0±8.9)mmol/L],차이유통계학의의(P＜0.05).술후각시간점SCr、BUN수평량조간비교차이무통계학의의(P＞0.05).술후7d내칠불완조유1례(3.2％)환자수요행혈액투석치료,이불완조역유1례(3.2％)환자수요행혈액투석치료,량조비교차이무통계학의의(P＞0.05).결론 대우엄중골절행전신마취수술적환자,칠불완여이불완균대신공능무현저불량영향,인차대우차류환자사용칠불완행마취치료가행,치득림상추엄응용.
[Objective] To investigate the effect of sevoflurane and isoflurane anesthesia on the renal function of patients with severe fracture after surgery.[Methods] Sixty-two patients with severe fracture who needed surgery were enrolled and all received general anesthesia.All the patients were divided by random digits table method into two groups with 31 cases each:sevoflurane group(anesthesia maintenance with 1.5％-3.0％ sevoflurane)and isoflurane group(anesthesia maintenance with 1.5％-3.0％ isoflurane).The patients in two groups received 0.1-0.2 μg/(kg·min)remifentanll continuous intravenous infusion and atracuurium intermittent intravenous injection for anesthesia maintenance.Serum creatinine(SCr)and blood urea nitrogen(BUN)in two groups after surgery were compared,as well as the number of hemodialysis.[Results]SCr and BUN at 1,3,7 d after surgery in two groups were significantly lower than those before surgery[seveflurane group:(517 ± 187),(163 ± 110),(103 ± 99)μ mol/L vs.(853 ± 220)μmol/L,(17.1 ± 7.8),(9.5 ± 4.1),(9.7 ± 3.8)mmol/L vs.(21.8 ± 9.3)mmol/L;isoflurane group:(539 ± 188),(136 ± 108),(101 ± 95)μ mol/L vs.(881 ± 220)μmol/L,(17.5 ± 7.4),(9.5 ± 3.5),(9.8 ± 3.3)mmol/Lvs.(20.0 ± 8.9)mmol/L](P ＜ 0.05).SCr and BUN between two groups at every time point after surgery had no statistical significance(P ＞ 0.05).There was 1 case(3.2％)in sevoflurane group needed hemodialysis within 7 d after surgery,as well as in isoflurane group,and there was no statistical significance between two groups(P＞0.05).[Conclusions] For patients with severe fracture who need general anesthesia and surgery,sevoflurane and isoflurane both have no significant adverse reaction to renal function.Therefore,it is acceptable for the patients to use sevoflurane for anesthesia and it is worthy of clinical popularization and application.
