摘要
目的探讨七氟醚静吸复合麻醉对原位肝移植患者围手术期脑氧代谢及血清P物质、5-羟色胺水平的影响.方法将54例原位肝移植患者按随机数字表法分为两组,各27例.对照组予以异氟醚静吸复合麻醉,观察组予以七氟醚静吸复合麻醉.比较两组术前、无肝前期、无肝期35 min、新肝期30 min、新肝期2 h、新肝期12 h的血流动力学指标(心率、平均动脉压)、脑氧代谢指标(脑氧摄取率、颈静脉血氧含量)检测结果及术后12 h、24 h致痛物质(血清P物质、5-羟色胺)水平、苏醒质量及不良反应发生率.结果术前、新肝期12 h两组血流动力学及脑氧代谢指标检测结果比较差异无统计学意义(P>0.05).无肝前期—新肝期2 h观察组平均动脉压及脑氧摄取率显著高于对照组(P<0.05或0.01),心率及颈静脉血氧含量显著低于对照组(P<0.05或0.01).术后12 h、24 h观察组血清P物质及5-羟色胺水平显著低于对照组(P<0.05或0.01).观察组自主呼吸及定向力恢复时间显著早于对照组(P<0.01).两组不良反应发生率比较差异无统计学意义(P>0.05).结论七氟醚静吸复合麻醉应用于原位肝移植患者对围手术期血流动力学、脑氧代谢影响较小,可明显提高苏醒质量,减轻术后疼痛程度,且不增加不良反应.
Objective To investigate the effects of sevoflurane inhalation combined anesthesia on cerebral oxygen metabolism and serum SP,5-HT levels in patients with orthotopic liver transplantation.Methods A total of 54 patients with orthotopic liver transplantation were divided into two groups according to the random number table method,27 cases each.The control group was given anesthesia with isoflurane,and the observation group was given anesthesia with sevoflurane.Compare the hemodynamic parameters(heart rate,mean arterial pressure),cerebral oxygen metabolism indicators(CERO2,SjvO2)of the two groups at T1,T2,T3,T4,T5,T6.The levels of pain-promoting substances(SP,5-HT),quality of recovery and the incidence of adverse reactions were compared at 12 and 24 hours after surgery.Results There was no significant difference in MAP and HR between the two groups at T1 and T6(P>0.05).The MAP of the observation group was higher than that of the control group at T2~T5(P<0.05 or 0.01),and the HR and SjvO2 were lower than the control group(P<0.05 or 0.01).The levels of SP and 5-HT in the observation group at 12 h and 24 h after surgery were significantly lower than those in the control group(P<0.05 or 0.01).The recovery time of spontaneous breathing and orientation was shorter in the observation group than in the control group(P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions The application of sevoflurane inhalation combined anesthesia in patients with orthotopic liver transplantation has little effect on perioperative which can significantly improve the quality of recovery and reduce postoperative pain without increasing adverse reactions.
作者
杨光辉
李红军
樊青
吴晓顺
Yang Guanghui;Li Hongjun;Fan Qing;Wu Xiaoshun(Zheng zhou People's Hospital,Zheng zhou 450003,Henan,China)
出处
《临床心身疾病杂志》
CAS
2020年第3期68-72,共5页
Journal of Clinical Psychosomatic Diseases
关键词
原位肝移植
七氟醚
静吸复合麻醉
脑氧代谢
P物质
5-羟色胺
Orthotopic liver transplantation
sevoflurane
intravenous inhalational anesthesia
cerebral oxygen metabolism
SP
5-HT
