[1]吕绪磊,郝建华.气管插管后七氟醚预处理麻醉对肝门阻断术中患者的肠保护作用[J].新乡医学院学报,2016,33(4):305-307.[doi:10.7683/xxyxyxb.2016.04.014]
　LYU Xu-lei,HAO Jian-hua.Sevoflurane preconditioning after tracheal intubation for intestinal protection in hepatic portal occlusion operation[J].Journal of Xinxiang Medical University,2016,33(4):305-307.[doi:10.7683/xxyxyxb.2016.04.014]
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气管插管后七氟醚预处理麻醉对肝门阻断术中患者的肠保护作用
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
33
期数:
2016年4
页码:
305-307
栏目:
临床研究
出版日期:
2016-04-06

文章信息/Info

Title:
Sevoflurane preconditioning after tracheal intubation for intestinal protection in hepatic portal occlusion operation
作者:
吕绪磊; 郝建华
（中国人民解放军总医院第一附属医院麻醉科，北京　100048）
Author(s):
LYU Xu-lei; HAO Jian-hua
(Department of Anesthesia,the First Affiliated Hospital of Chinese PLA General Hospital，Beijing 100048,China)
关键词:
肠保护; 肝门阻断术; 七氟醚; 炎性反应
Keywords:
intestinal protection; hepatic portal occlusion operation; sevoflurane; inflammatory reaction
分类号:
R614
DOI:
10.7683/xxyxyxb.2016.04.014
文献标志码:
A
摘要:
目的　评价气管插管后七氟醚预处理对行肝门阻断术患者肠道的保护作用。方法　选择解放军总医院第一附属医院确诊为右肝癌的患者52例，美国麻醉医师协会分级Ⅱ～Ⅲ级，肝功能分级A级，按照随机对照原则分为对照组和七氟醚组，每组26例，2组患者在术中均行肝门阻断术，其中七氟醚组患者在气管插管后给予七氟醚吸入麻醉，对照组患者未采取吸入麻醉措施。对2组患者的术中情况及麻醉诱导前（T1）、肝门阻断时（T2）、肝门开放后 1 h（T3）、3 h（T4）、6 h（T5）和术后24 h（T6）时的血清肿瘤坏死因子-α(TNF-α)、D乳酸盐、肠脂肪酸结合蛋白(I-FABP)水平进行检测分析。结果　2组患者的手术时间、术中出血量、肿瘤切除直径、肝门阻断时间比较差异均无统计学意义（P>0.05）。2组患者血清TNF-α、D乳酸盐水平均从T3时开始上升，T5时达到最高水平。而血清 I-FABP 水平从T3时开始上升，T4时达到最高水平。七氟醚组患者T3～T6时血清TNF-α、D乳酸盐及I-FABP均显著低于对照组（P<0.05）。结论　气管插管后七氟醚预先吸入麻醉能够显著抑制机体的炎性反应，从而在肝门阻断术中对肠道产生一定的保护作用。
Abstract:
Objective　To evaluate sevoflurane preconditioning after tracheal intubation for intestinal protection in hepatic portal occlusion operation.Methods　Fifty-two patients with right liver cancer from the First Affiliated Hospital of Chinese PLA General Hospital were divided into control group and sevoflurane group,with 26 patients in each group,American society of anesthesiologist of all the patients was Ⅱ-Ⅲ,and Child-Pugh of all the patients was A.All patients received hepatic portal occlusion operation.The patients in sevoflurane group were given sevoflurane inhalation anesthesia after tracheal intubation,while the control group didn′t be given inhalation anesthesia measures.The intraoperative conditions of patients in the two groups were observed，and tumor necrosis factor-α（TNF-α），D-lactate and intestinal fatty acid binding protein（I-FABP）in before induction(T1)，immediately after hepatic portal was clamped(T2)，at 1 h(T3)，3 h(T4)and 6 h(T5)after occlusion of hepatic portal was released and at 24 h after operation(T6) were detected.Results　There was no significant difference in operation time,intraoperative blood loss,the diameter of tumor resection,hepatic portal occlusion time between the two groups（P>0.05）.TNF-α and D-lactate level were began to rise from T3，and achieved the highest level at T5.The I-FABP level was began to rise from T3，and achieved the highest level at T4.The TNF-α，D-lactate and I-FABP levels of sevoflurane group were significantly lower than those of control group at T3-T6（P<0.05）.Conclusion　Sevoflurane preconditioning after tracheal intubation could significantly inhibit inflammatory response,and give certain protective effect on the intestinal tract in hepatic portal occlusion operation.

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更新日期/Last Update: 2016-04-05