七氟烷对肝移植术患者心肌损害保护作用的研究

Effect of sevoflurane on myocardial preservation in orthotopic liver transplantation

目的:观察七氟烷对肝移植术患者心肌损害的保护作用。方法:30例行原位肝移植患者随机分为对照组和七氟烷组,每组各15例。麻醉诱导后,七氟烷组采用异丙酚TCI+七氟烷1MAC麻醉维持;对照组采用异丙酚TCI麻醉维持。两组患者均连续监测心电图,记录心律失常发生的时间和类型,并于术前、麻醉后、无肝前期、无肝期、新肝期、术毕12小时的6个时间点抽血测定血浆CK、CK-MB及cTnI的浓度。结果:七氟烷组共发生心律失常16例次,明显少于对照组36例次,无肝前期、无肝期、新肝期、术毕12小时内同种类型和同一时间段心律失常发生例次七氟烷组少于对照组。七氟烷组CK、CK-MB及cTnI在无肝前期、无肝期、新肝期、术毕12小时显著低于对照组(P<0.05)。结论:七氟烷对肝移植术患者心肌损害具有保护作用。

Objective：To investigate the effect of sevoflurane on myocardial preservation in orthotopic liver transplantation.Methods：30 patients undergoing orthotopic liver transplantation were randomly divided into 2 groups with 15 patients each.After induction of anesthesia,Anesthesia was maintained with propofol TCI＋1MAC sevoflurane in the sevoflurane group,while propofol TCI was maintained in the control group.ECGs were continuously monitored,the time and type of arrhythmia were recorded.Blood samples were taken before operation,after anesthesia,before surgery,pre-anhepatic,anhepatic phase,the new liver stage and 12 hours after surgery to determine plasma creatine kinase（CK）,creatine kinase isoenzyme MB（CK-MB） and cardiac troponin（cTnI） concentrations.Results：Arrhythmia（16 times） was significantly lower than that in the control group（36 times）.The incidence of all types of arrhythmia in the sevoflurane group was also significantly lower than that in the control group at pre-anhepatic,anhepatic phase,the new liver stage and 12 hours after surgery.The concentrations of CK、CK-MB and cTnI in the sevoflurane group were significantly lower than those in the control group at pre-anhepatic,anhepatic phase,the new liver stage and 12 hours after surgery.Conclusion：Sevoflurane is effective for myocardial preservation in orthotopic liver transplantation.