低流量七氟醚麻醉对术后肝肾功能的影响

Effects of low-flow sevoflurane anesthesia on hepatic and renal function

目的观察低流量七氟醚麻醉后肝、肾功能的变化。方法神经外科择期手术患者35例,采用七氟醚低流量麻醉。监测呼吸环路内氟甲基二氟乙烯醚(compound A)的体积分数;采集术前、术毕及术后2、24、72 h的静脉血,检测血清氟离子(F^-)、谷胱甘肽S-转移酶(GST)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、肌酐(Cr)和尿素氮(BUN)水平。留取术前、术毕及术后24、48、72 h的尿样,检测总蛋白(TP)、β_2微球蛋白(β_2-MG)和β-N-乙酰氨基葡萄糖苷酶(NAG)水平。结果 compound A体积分数最高为(36.37±9.72)×10^(-6),血清F^-浓度最高达(23.12±7.68)μmol·L^(-1),麻醉后除TP、β_2-MG一过性增高外(P<0.05),其他指标变化无统计学意义(P>0.05)。增高的TP和β_2-MG分别与compound A体积分数之间不具有相关性。结论低流量七氟醚麻醉后除TP、β_2-MG一过性增高外,对肝、肾功能没有明显影响。

A/M To observe the effects of low-flow sevoflurane anesthesia on hepatic and renal function. METHODS Thirty-five patients, American Society of Anesthesiologists physical status Ⅰ -Ⅱ, scheduled for neurosurgery operation received low-flow scvoflurane anesthesia. Compound A concentrations were detemained by gas chromatography at 30 min intervals. Venous blood was obtained on the morning of surgery, at the end of anesthesia, and at 2,24 and 72 h after anesthesia. Urine samples were obtained on the morning of surgery, at the end of anesthesia, and at 24,48 and 72 h after anesthesia. Blood and urine samples were evaluated by laboratory tests for hepatic and renal function indices. Serum inorganic fluoride was also measured. RESULTS The peak concentration of compound A was （36.37 ± 9.72） × 10-6. rFne maximum concentration of serum F- was （23.12± 7.68）μmol·L-1. The concentration of urine protein and β2-MG after operation was higher than that before operation （ P 〈 0.05） and the other indices did not change （ P 〉 0.05）.There are no significant correlations between the concentrations of protein or β2-MG after operation and compound A. CONCLUSION There were no statistically significant differences between preoperative and postoperative hepatic and renal function, except that after operation the concentrations of urine protein and β2-MG have a transient rise.