全程七氟醚维持麻醉对心脏手术患者体外循环缺血再灌注损伤心肌的影响

Effect of sevoflurane whole-course maintenance of anesthesia on myocardial ischemia reperfusion injury under extracorporeal circulation in patients undergoing cardiac surgery

目的探讨全程七氟醚维持麻醉对心脏手术患者体外循环缺血再灌注损伤心肌的影响。方法随机双盲法将80例心脏手术患者分为两组，各40例，A组采取全程七氟醚维持麻醉，B组则行丙泊酚全程麻醉，比较两组不同时间点心率、中心静脉压、平均动脉压、心肌肌钙蛋白I（cTnI）及血浆肌酸激酶同工酶（CK-MB）水平。结果两组不同时间点心率、平均动脉压、中心静脉压组间比较差异均无统计学意义（P〉0．05）。A组主动脉开放后2、8、24、48h时cTnI、CK-MB水平明显低于B组，差异有统计学意义（P〈0．05）。结论全程七氟醚维持麻醉能明显减轻体外循环下心脏手术患者缺血再灌注心肌损伤，且能维持血流动力学稳定。

Objective To investigate the effect of sevoflurane whole-course maintenance of anesthesia on myocardial ischemia reperfusion injury under extracorporeal circulation in patients undergoing cardiac surgery. Methods 80 patients undergoing cardiac surgery were randomly divided into two groups by randomized and double blind method, with 40 cases in each group. Group A received sevoflurane whole-course maintenance of anesthesia, while group B received propofol whole-course anesthesia. Heart rate, central venous pressure, mean arterial pressure, cardiac troponin I （cTnI） and plasma creatine kinase isoenzyme （CK-MB） levels in two groups at different time points were compared. Results There were no statistically significant differences in heart rate, mean arterial pressure and central venous between two groups at different time points （P〉0.05）. The levels of cTnl and CK-MB at 2 h, 8 h, 24 h and 48 h after opening aorta in group A were significantly lower than those in group B （P〈0.05）. Conclusion Sevoflurane whole-course maintenance of anesthesia can significantly reduce myocardial ischemia reperfusion injury under extracorporeal circulation in patients undergoing cardiac surgery, and maintain the stability of hemodynamics.