异氟烷与七氟烷对肝移植患者心肌保护作用的对比观察

The comparative study of myocardial protective effects in liver transplant patients with isoflurane and sevoflurane

目的观察对比异氟烷与七氟烷对肝移植患者心肌的保护作用。方法随机将26例行原位肝移植的患者分为异氟烷组和七氟烷组各13例;术中,异氟烷组采用异丙酚TCI与异氟烷1MAC麻醉维持、七氟烷组采用异丙酚TCI与七氟烷1MAC麻醉维持;检测两组患者在术前、麻醉后、无肝前期、无肝期、新肝期、术毕12h等6个时相血浆CK、CK-MB及cTnI的浓度。结果七氟烷组患者血浆CK、CK-MB及cTnI浓度在无肝前期、无肝期、新肝期及术毕12h等时相均显著低于异氟烷组,差异有统计学意义(P<0.05)。结论七氟烷对肝移植术患者心肌有保护作用。

Objective Myocardial protection in the liver transplant patients with isoflurane and sevoflurane were compared.Methods Twenty-six cases of orthotopic liver transplant patients were randomly divided into the isoflurane group and sevoflurane group,13 cases in each group.During surgery,the cases in the isoflurane group were adopted TCI of propofol and 1MAC isoflurane to anesthesia,and propofol TCI and the sevoflurane 1MAC were used to maintain anesthesia in the sevoflurane group.The plasma CK,CK-MB and cTnI activity were measured in all patients at six-phase of before surgery,after anesthesia,before anhepatic phase,anhepatic phase,new liver and 12 hours after surgery.Results The plasma CK,CK-MB and cTnI concentrations in 4 phases of before anhepatic phase,anhepatic phase,new liver and the 12 hours after surgery in the sevoflurane group were significantly lower（P〈0.05） than that in the Isoflurane group.Conclusion Sevoflurane has myocardial protection in patients with liver transplantation.