CAJ | 학술논문

目的:探讨不同吸入性麻醉药对小儿法洛四联症术后肝功能的影响.方法:选择在体外循环下择期行法洛四联症根治术患儿30例,随机分为3组(n=10),全凭静脉全麻组(对照组);静脉复合吸入异氟醚全麻组;静脉复合吸入七氟醚全麻组;静脉复合吸入麻醉药全麻组其维持麻醉期间的静脉镇静药由吸入麻醉药代替,三组的肌松药和镇痛药品种及用量相同.三组分别于术前、术后6h、12h、24h、48h 五个时间点采集血样监测肝功能指标(包括:血ALT、AST、GGT、胆红素),结果:三组病例术中一般情况无统计学差异(P>0.05).肝功能指标:三组病例的术后 ALT、胆红素水平升高(P﹤0.05),但组间比较无统计学差异(P>0.05);三组 GGT 水平术后无显著变化(P>0.05),组间亦无差异(P>0.05);三组的术后 AST 水平升高(P﹤0.05),七氟醚组术后48hAST 水平较对照组低(P﹤0.05),余个时间点无统计学差异(P>0.05).结论:全麻体外循环下行法洛四联症根治术对患儿术后肝功能存在一定损害;异氟醚、七氟醚对小儿法洛四联症术后肝功能指标的影响无差别.
목적:탐토불동흡입성마취약대소인법락사련증술후간공능적영향.방법:선택재체외순배하택기행법락사련증근치술환인30례,수궤분위3조(n=10),전빙정맥전마조(대조조);정맥복합흡입이불미전마조;정맥복합흡입칠불미전마조;정맥복합흡입마취약전마조기유지마취기간적정맥진정약유흡입마취약대체,삼조적기송약화진통약품충급용량상동.삼조분별우술전、술후6h、12h、24h、48h 오개시간점채집혈양감측간공능지표(포괄:혈ALT、AST、GGT、담홍소),결과:삼조병례술중일반정황무통계학차이(P>0.05).간공능지표:삼조병례적술후 ALT、담홍소수평승고(P﹤0.05),단조간비교무통계학차이(P>0.05);삼조 GGT 수평술후무현저변화(P>0.05),조간역무차이(P>0.05);삼조적술후 AST 수평승고(P﹤0.05),칠불미조술후48hAST 수평교대조조저(P﹤0.05),여개시간점무통계학차이(P>0.05).결론:전마체외순배하행법락사련증근치술대환인술후간공능존재일정손해;이불미、칠불미대소인법락사련증술후간공능지표적영향무차별.
Objection:To discuss the influences of general anesthesia with different inhalation anesthetics on postoperative liver function of children with tetralogy of Falot.Methods:30 children with tetralogy of Falot underwent elective total correction are chosen, divided into 3 groups randomly (n=10), total intravenous anesthesia group (control group); intravenous combined with isoflurane inhalation general anesthesia group; intravenous combined with sevoflurane inhalation general anesthesia group; intravenous sedatives for anesthesia maintenance is replaced by inhalation anesthetics in groups of intravenous inhalation combination, the types and doses of muscle relaxants and narcotics are the same in three groups. Blood samples were taken from three groups at five different time points: pre-op, 6h, 12h, 24h, 48h post-op, indexes of live function are measured (including: ALT, AST, GGT,bilirubin).Results:There is no statistic difference in general conditions during surgery between three groups (P>0.05). Liver function index: postoperative ALT and bilirubin are elevated in al three groups (P﹤0.05), but there is no statistic difference between three groups (P>0.05); there is no significant changes in GGT level postoperatively in three groups (P>0.05), and there is no statistic difference between groups either (P>0.05); postoperatively AST level in al three groups are elevated (P﹤0.05), AST level in sevoflurane group is lower than the control at 48h postoperative (P﹤0.05), and no statistic difference at any other time points (P>0.05).Conclusion: Postoperative liver function can somehow be compromised by total correction of tetralogy of Falot under general anesthesia and cardiac pulmonary bypass; isoflurane, sevoflurane have similar effects on postoperative liver function index in children with tetralogy of Falot.