丙泊酚与七氟烷麻醉对肝切除术患者术后炎症因子和肝脏功能的影响比较

Efficacy of propofol compared with sevoflurane on inflammatory factor and liver function after hepatectomy

目的探讨丙泊酚和七氟烷麻醉对肝切除术患者术后炎症因子和肝脏功能的影响。方法选取40例肝切除术患者,随机分为丙泊酚组(P组)、七氟烷组(S组),每组20例。P组和S组分别丙泊酚靶控注射或吸入七氟醚维持麻醉。比较2组患者手术前后丙氨酸氨基转移酶(alanine aminotransferase,ALT)、总胆红素(total bilirubin,TBil)、天门冬氨酸氨基转移酶(aspartate amino transferase,AST)、白蛋白(albumin,ALB)及血浆肿瘤坏死因子-α(tumor necrosis factor,TNF-α)、白介素-6(interleukin-6,IL-6)、白介素-10(interleukin-10,IL-10)水平。统计2组患者并发症发生率。结果术后1、3、7 d,S组AST、ALT、TBi L水平显著低于P组(P<0.05),但2组ALB水平差异无统计学意义,S组血浆TNF-α、IL-6及IL-10显著低于P组(P<0.05)。S组术后发生并发症的患者为6(30.0%)例,与P组的10(20.0%)例比较差异无统计学意义(χ2=1.67,P>0.05)。结论七氟烷吸入可有效抑制肝切除术后血浆炎症因子分泌,促进肝功能恢复,其效果优于丙泊酚。

Objective To evaluate efficacy of propofol compared with sevoflurane on inflammatory factor and liver function after hepatectomy.Methods 40 cases with hepatectomy were divided into propofol group（ P group） and sevoflurane group（ S group）,20 cases in each group. The P group and S group respectively were given propofol or sevoflurane maintained anesthesia. The alanine aminotransferase（ ALT）,total bilirubin（ TBil）,aspartate amino transferase（ AST）,albumin（ ALB）,plasma tumor necrosis factor（ TNF-α）,interleukin-6（ IL-6）,interleukin-10（ IL-10） and complication rate were compared between two groups. Results Postoperation 1d,3d and 7d,the AST,ALT,and TBi L levels of S group were significantly lower than those of P group（ P〈0. 05）. There was no significant difference of ALB level between two groups. The plasma TNF-α,IL-6 and IL-10 levels of S group were significantly lower than those of P group（ P〈0. 05）. There was no significant differece of the rate of postoperative complications between S group and P group [6（ 30. 0%） vs. 10（ 20. 0%）; χ2= 1. 67,P〉0. 05]. Conclusion Sevoflurane inhalation could effectively inhibit the plasma inflammatory cytokines secretion after hepatectomy,and promote liver function recovery,its effect is better than that of propofol.