两种不同麻醉方式对肝癌手术患者肝功能影响的比较
R614%R735.7; 目的 观察比较静-吸复合全麻和硬膜外联合静脉麻醉对肝癌手术患者肝功能的影响.方法 选择ASAⅠ～Ⅱ级Child-Pugh分类为A级的肝叶切除患者30例,随机分为联合组,对照组各15例.联合组于T8～9穿刺置管,注入0.2%罗呱卡因5 ml确定麻醉平面后,行气管插管,之后每小时硬腹外导管推注0.2%罗呱卡因5～7ml,直至术毕.同时将异丙酚200mg+瑞芬太尼0.2mg合剂以异丙酚40～60μg/(kg·min)-1输注.对照组持续吸入异氟醚间断静注芬太尼.两组患者于入室后(d0)、术后第1天(d1)、第3天(d2)、第5天(d3)、和第7天(d4)做肝功能的测定.入室...
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| Published in | 肿瘤防治研究 Vol. 33; no. 8; pp. 605 - 608 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
430079,湖北省肿瘤医院麻醉科%广州军区武汉总医院麻醉科
2006
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1000-8578 |
| DOI | 10.3971/j.issn.1000-8578.2006.08.019 |
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| Abstract | R614%R735.7; 目的 观察比较静-吸复合全麻和硬膜外联合静脉麻醉对肝癌手术患者肝功能的影响.方法 选择ASAⅠ～Ⅱ级Child-Pugh分类为A级的肝叶切除患者30例,随机分为联合组,对照组各15例.联合组于T8～9穿刺置管,注入0.2%罗呱卡因5 ml确定麻醉平面后,行气管插管,之后每小时硬腹外导管推注0.2%罗呱卡因5～7ml,直至术毕.同时将异丙酚200mg+瑞芬太尼0.2mg合剂以异丙酚40～60μg/(kg·min)-1输注.对照组持续吸入异氟醚间断静注芬太尼.两组患者于入室后(d0)、术后第1天(d1)、第3天(d2)、第5天(d3)、和第7天(d4)做肝功能的测定.入室(t0)、阻断肝门(t1)、恢复肝血流(t2)、恢复肝血流后1小时(t3)、术毕(t4)监测血流动力学.结果 1.术毕联合组睁眼时间、自主呼吸恢复时间、拔管时间均明显低于对照组,清醒程度明显优于对照组(P＜0.01).2.两组ALT、AST d1时两组均极显著上升(P＜0.01),但联合组明显低于对照组(P＜0.01).d2～d3时联合组恢复正常,而对照组至d4时恢复正常.两组TBIL在d1开始升高,联合组明显低于对照组(P＜0.05).d4时均恢复正常.3.血流动力学方面:联合组各观察点均比较平稳而对照组t1、t2、t3有差异(P＜0.05).结论 硬膜外联合全身麻醉更有利于肝癌肝叶切除患者的手术. |
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| AbstractList | R614%R735.7; 目的 观察比较静-吸复合全麻和硬膜外联合静脉麻醉对肝癌手术患者肝功能的影响.方法 选择ASAⅠ～Ⅱ级Child-Pugh分类为A级的肝叶切除患者30例,随机分为联合组,对照组各15例.联合组于T8～9穿刺置管,注入0.2%罗呱卡因5 ml确定麻醉平面后,行气管插管,之后每小时硬腹外导管推注0.2%罗呱卡因5～7ml,直至术毕.同时将异丙酚200mg+瑞芬太尼0.2mg合剂以异丙酚40～60μg/(kg·min)-1输注.对照组持续吸入异氟醚间断静注芬太尼.两组患者于入室后(d0)、术后第1天(d1)、第3天(d2)、第5天(d3)、和第7天(d4)做肝功能的测定.入室(t0)、阻断肝门(t1)、恢复肝血流(t2)、恢复肝血流后1小时(t3)、术毕(t4)监测血流动力学.结果 1.术毕联合组睁眼时间、自主呼吸恢复时间、拔管时间均明显低于对照组,清醒程度明显优于对照组(P＜0.01).2.两组ALT、AST d1时两组均极显著上升(P＜0.01),但联合组明显低于对照组(P＜0.01).d2～d3时联合组恢复正常,而对照组至d4时恢复正常.两组TBIL在d1开始升高,联合组明显低于对照组(P＜0.05).d4时均恢复正常.3.血流动力学方面:联合组各观察点均比较平稳而对照组t1、t2、t3有差异(P＜0.05).结论 硬膜外联合全身麻醉更有利于肝癌肝叶切除患者的手术. |
| Author | 余鸣 沈七襄 蹇新民 薛亚军 张曙明 杜嘉陵 |
| AuthorAffiliation | 430079,湖北省肿瘤医院麻醉科%广州军区武汉总医院麻醉科 |
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| Author_FL | ZHANG Shu-ming DU Jia-ling SHEN Qi-xiang XUE Ya-jun JIAN Xin-min YU Ming |
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| Keywords | 麻醉 原发性肝癌 肝功能 |
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