七氟烷麻醉与丙泊酚麻醉对腹腔镜直肠癌根治术患者术后肝功能的影响

Influence of sevoflurane anesthesia and propofol anesthesia on Postoperative liver function in patients underwent laparoscopic radical resection of rectal cancer

目的探讨七氟烷维持麻醉和丙泊酚维持麻醉对腹腔镜直肠癌根治术患者术后肝功能的影响。方法选取本院2014年3~12月行腹腔镜下直肠癌根治术（Dixon术）的60例直肠癌患者作为研究对象,随机分为Pro组和Sev组,各30例。Pro组采用丙泊酚麻醉,Sev组采用七氟烷麻醉。比较两组不同时间点的血压和心率以及乳酸脱氢酶（LDH）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、碱性磷酸酶（ALP）和胆红素（TBi L）水平。结果两组的麻醉时间、手术时间、气腹时间和瑞芬太尼总用量比较,差异无统计学意义（P〉0.05）。两组不同时间点的血压和心率比较,差异无统计学意义（P〉0.05）。两组术后24、72 h的LDH、AST、ALT、ALP和TBi L水平与术前比较,差异无统计学意义（P〉0.05）。两组术后24、72 h的LDH、AST、ALT、ALP和TBi L水平比较,差异无统计学意义（P〉0.05）。结论七氟烷维持麻醉和丙泊酚维持麻醉对腹腔镜下直肠癌根治术（Dixon术）患者的肝功能影响相近。

Objective To explore the influence of sevoflurane anesthesia and propofol anesthesia on postoperative liver function in patients underwent laparoscopic radical resection of rectal cancer. Methods 60 patients underwent laparoscopic radical resection of rectal cancer（Dixon surgery） from March 2014 to December in our hospital were selected and randomly divided into the Pro group and the Sev group,30 cases in each group.The Pro group was given propofol anesthesia,the Sev group was given sevoflurane anesthesia.The blood pressure and heart rate at different time points,the level of lactate dehydrogenase（LDH）,alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,alkaline phosphatase（ALP） and bilirubin（TBi L） was compared between the two groups respectively. Results Compared with anesthesia and surgery time,pneumoperitoneum time and total dosage of remifentanil between two groups,the difference was not significant difference（P 0.05）.There was no statistically significant difference in MAP and HR at different time points between the Sev group and the Pro groups（P0.05）.Compared with preoperative,there were no significant difference in the level of LDH,ALT,AST,ALP and TBi L postoperative 24,72 h（P0.05）.There was no significant difference in the level of LDH,ALT,AST,ALP and TBi L between postoperative 24 h and 72 h in the two groups（P0.05）. Conclusion The influence of sevoflurane anesthesia and propofol anesthesia on liver function in patients underwent laparoscopic radical resection of rectal cancer is similar.