普外科手术患者实施紧闭循环麻醉时七氟醚对肝肾功能的影响研究

Study on the Effect of Sevoflurane on the Liver and Kidney Function Closed Loop Anesthesia for Patients with Department of General Surgery Operation

目的：对普外科手术当中七氟醚在紧闭循环麻醉中对肝肾功能的影响进行研究和探讨。方法将52例普外科手术患者经随机的方式均匀分为七氟醚组和异氟醚组，两组患者在手术前进行相应的麻醉，在麻醉前30 min对其注射相应的咪唑安定0．05 mg／kg，然后根据需要对两组患者依次进行静脉注射异丙酚1～2 mg／kg、芬太尼1．6～2．1μg／kg以及咪唑安定0．1 mg／kg等进行相应的麻醉诱导，异氟醚组在异氟醚呼气末的二氧化碳分压保持在相应的1．1％～1．6％的范围之内，七氟醚组的七氟醚呼气末其浓度应保持在相应的2．8％～4．1％的范围内，在手术的过程中使用芬太尼药剂，从而将心率及血压的变化幅度保持下基础值波动范围内的20％范围内。然后进行维库溴铵的间断注射。结果七氟醚组与异氟醚组在手术的前后过程中其肝功能相应指标无明显性差异（P＞0．05）；七氟醚组患者手术前在尿素氮、微球蛋白（β2－MG）以及肌酐等方面与手术后比较无明显差异（P＞0．05），而在术后1，2，3 d相应的尿液微球蛋白（β2－MG）明显高于手术前水平，并在手术后4 d降至术前水平。结论七氟醚在紧闭循环麻醉中的使用，对患者相应的肝肾功能没有明显性的影响。

Objective To study the operation of sevoflurane in the Department of general surgery and the discussion in the closed cycle effect on liver and renal function during anesthesia .Methods 52 cases of patients in Department of general surgery operation by random evenly divided into sevoflurane group and isoflurane group , two groups of patients with the corresponding anesthesia before the operation , at 30 min before anesthesia on the corresponding injection of mid-azolam 0.05 mg/kg, then according to the needs of two groups of patients were followed by intravenous injection of propofol , fentanyl 1～2 mg/kg 1.6 ～2.1 g/kg and mg/kg were induced by midazolam 0.1 corresponding anesthetic isoflurane group , isoflurane in end expiratory PCO 2 remains within the range of the corresponding 1.1% ～1.6%, sevoflurane group sevoflurane concentration should be maintained in the range of the corresponding 2.8%～4.1%, the use of fentanyl medicament in the operation process , which will change the heart rate and amplitude keep the blood pres-sure under the basic value fluctuation range within the range of 20%.Then the intermittent injection of vecuronium .Re-sults sevoflurane group and isoflurane group in operation before and after the liver function indices without significant difference （P〉0.05）;sevoflurane group of patients before surgery in urea nitrogen , albumin microspheres （β2 -MG） and creatinine and after surgery no significant difference （P〉0.05）, and in the postoperative 1, 2, 3 corresponding u-rine microglobulin （β2 -MG） was significantly higher than that of preoperative levels , and in the operation after 4 days down to the preoperative level .Conclusions sevoflurane anesthesia in the closed loop , no obvious effect on liver and kidney function in patients with the corresponding .