七氟烷麻醉对肝切除术患者术后炎症应激反应程度与肝功能的影响

Effect of seven sevoflurane anesthesia on the degree of inflammation and liver function in patients after hepatectomy

目的探讨七氟烷麻醉对肝切除术患者术后炎症应激反应程度与肝功能的影响。方法选择2014年7月～2015年7月期间我院收治的肝硬化并择期行肝右叶切除术患者60例为研究对象。将研究对象随机分为试验组，采用七氟烷麻醉，30例；对照组，采用丙泊酚麻醉，30例。观察炎症应激反应因子TNF-α、IL-6和IL-10水平；肝功能指标ALT、TBil、AST和ALB；统计并发症发生率。采用SPSS20．0软件进行统计学分析。结果（1）术后1d、3d．7d，两组患者TNF-α、IL-6及IL-10水平均较术前显著升高（P〈0．05），且试验组TNF-α、IL-6及IL-10水平显著低于对照组（P〈0．05）。（2）术后1、3、7d，两组患者AST、ALT和TBiL均较术前显著升高（P〈0．05），且试验组AST、ALT和TBiL水平低于对照组（P〈0．05），两组患者ALB术前术后均无差异（P〉0．05）。（3）两组患者术后并发症比较无统计学差异（P〉0．05）。结论七氟烷麻醉抑制了患者术后炎症应激反应因子的分泌，促进了患者术后肝功能恢复，不能明显降低患者术后并发症的发生，效果优于丙泊酚。

Objective To analysis the effect of seven sevoflurane anesthesia on the degree of inflammation and liver function in patients after hepatectomy. Methods 60 cases of patients with cirrhosis treated in our hospital during the period from July 2014 to July 2015 were selected as the study subjects. The research subjects were randomly divided into experimental group, 30 cases were an- esthetized with seven isoflurane, patients were control group and 30 patients were anesthetized with propofol. The levels of IL-10, IL- 6 and TNF- were observed, and liver function indexes were ALT, TBil, AST and ALB, and the incidence of statistical complication was observed. SPSS20. 0 software was used for statistical analysis. Results （ 1 ） postoperative 1 D, 3D, 7 TNF-, 2 groups of patients with D, IL-6 and IL-10 levels were significantly higher than the preoperative （P 〈 0.05 ）, and the experimental group TNF-, IL-6 and IL-10 levels were significantly lower than the control group （P 〈0. 05）. （2） after operation for 1,3, 7 days, 2 groups of AST in pa- tients, ALT and TBIL were compared with the preoperative significantly increased （ P 〈 0.05 ） and test group ast, ALT and TBIL level lower than in the control group （ P 〈 0. 05 ）. Two groups of Alb in patients with preoperative postoperative had no difference （ P 〉 0. 05 ）. （3） There was no significant difference in postoperative complications between the two groups （P 〉 0. 05）. Conclusion Sev- en isoflurane anesthesia can inhibit the secretion of inflammatory stress response factors, promote the recovery of postoperative liver function, can not significantly reduce the incidence of postoperative complications, the effect of seven isoflurane anesthesia is better than propofol.