七氟烷、异氟烷和恩氟烷在肝癌切除术中的应用

The application of sevoflurane,isoflurane and enflurane in liver carcinoma hepatectomy

目的观察七氟烷、异氟烷和恩氟烷全麻对肝癌切除术患者的影响。方法将80例ASAⅠ-Ⅱ级择期行肝癌切除术的病人随机分为四组：七氟烷组（S1组）、异氟烷组（S2组）、恩氟烷组（S3组）和对照丙泊酚组（P组）,每组20例。S1、S2、S3组分别行七氟烷、异氟烷和恩氟烷吸入麻醉,P组行丙泊酚静脉麻醉。观察四组患者麻醉前（基础值）、诱导后、插管后1 min、5 min、10min、切皮时、切皮后30 min、60 min、停药时、术毕、苏醒时、拔管时、拔管后1 min、5 min、10 min的MAP、HR。术后1 d、5 d、10 d、20d抽取病人静脉血,测定谷丙转氨酶（ALT）、谷草转氨酶（AST）水平。结果与基础值相比,四组在手术过程中,MAP、HR都有波动,但各组之间MAP无显著性差异（P〉0.05）,S2组HR较其他三组升高（P〈0.05）,但总体变化范围未超过±30%;与术前相比,术后四组患者的ALT、AST水平均有显著性差异（P〈0.05或0.01）,但各组相同时间点的ALT、AST水平均无显著性差异（P〉0.05）。结论七氟烷、异氟烷和恩氟烷应用于肝癌切除术麻醉,效果满意。

Objective To observe the effect of sevoflurane,isoflurane and enflurane in treating patients with liver carcinoma hepatectomy.Methods Eighty ASA Ⅰor Ⅱ patients undergoing elective liver carcinoma hepatectomy under general anesthesia were randomly allocated to one of four groups with 20 patients in each group：group S1,gave sevoflurane inhalation anesthesia;group S2,isoflurane;group S3,enflurane;group P,gave intravenous anesthesia of propofol.Observed the MAP、HR in all groups before hocus（baise values）,after inducement,1 min、5 min、10 min after trachea cannula and some other corresponding timepionts.The serum glutamic-pyruvic transaminase and glutamic-oxalacetic transaminase level were detected 1 d、5 d、10 d、20 d after the operation in all patients.Results There was no significant difference between the four groups on MAP（P〈0.05）.Compared with that before the operation,there was significant difference in all four groups on serum ALT、AST level（P〈0.05 or 0.01）,but there was no significant difference between the four groups（P〈0.05）.Conclusion Sevoflurane,isoflurane and enflurane could be great help in liver carcinoma hepatectomy.