不同麻醉方法对行肝切除术患者缺血再灌注损伤的影响

doi:10.3969/j.issn.1006-5253.2017.02.006

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Abstract Objective To explore and analyze the effects of different anesthesia methods on ischemia-reperfusion injury in patients undergoing hepatectomy. Methods Forty hospitalization patients with liver resection from January 2014 to January 2016 were selected and divided into observation group and control group according to random number table, 20 cases in each group. The control group was treated with sevoflurane and sulfentanyl, while the observation group was treated with propofol and remifentanil. We observed and recorded the general sitiuation and blood flow dynamics of hepatic portal occlusion before blocking, during blocking, 30min after blocking,60min after blocking, and one day after surgery, including heart rate, central venous pressure and mean arterial pressure (ALT), and aspartate aminotransferase (γ-GGT), gamma glutamyl transferase (MDA), MDA), T-SOD (superoxide dismutase) level. Results There was no significant difference in the general situation and in hemodynamic parameters such as HR, MAP and CVP before and after blocking of hepatic portal occlusion between the two groups (P>0.05). By the analysis of variance, ALT concentration difference of the two groups of patients before and after hepatic portal occlusion was statisticallysignificant (P<0.05), ALT concentration in patients increased during hepatic portal occlusion, and with the passage of time, ALT concentration of two groups decreased gradually, while ALT concentration of postoperative 1D patients significantly increased after blocking (P<0.05), but ALT concentration of observation group were significantly lower than that of control group (P<0.05), with statistical significance. Gamma γ-GGT concentration difference of the two groups of patients before and after hepatic portal occlusion was statistically significant (P<0.05). Gamma γ-GGT concentration of the observation group decreased after blocking, and 60min after blocking was significantly lower than that before blocking with statistical significance (P<0.05).Gamma γ-GGT concentration of the observation group one day after surgery increased,with no significant difference compared with that before blocking (P>0.05). Gamma γ-GGT concentration of the control group with hepatic portal occlusion one day after surgery didn't induced obviously, while that one day aftger surgery compared with that before blocking, with statistical significance (P<0.05). MDA concentration difference of the two groups of patients before and after hepatic portal occlusion was statistically significant (P<0.05). MDA concentration of the two groups of patients after hepatic portal occlusion increased,and reached to the highest one day after surgery, but the increase level of the obervation group was significantly lower than that of the control group, with statistical significance (P<0.05). T-SOD concentration difference of the two groups of patients before and after hepatic portal occlusion was statistically significant (P<0.05). T-SOD concentration of both groups after hepatic portal occlusion decreased, but the decrease level of the observation group was lower than that of the control group, with statistical significance (P<0.05). Conclusion Propofol remifentanil maintenance can effectively reduce liver resection in patients with hepatic portal occlusion after ischemia reperfusion injury, and compared with sevoflurane-sulfentanyl maintenance, it does not increase the hemodynamic fluctuations, so it is worthy of promotion.

Key words： sevoflurane sulfentanyl propofol remifentanil hepatectomy ischemia reperfusion injury

Received: 27 December 2016

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	Cen Shenghua
	Fu Haiqing
	Hu Jiayan

Cite this article:

Cen Shenghua,Fu Haiqing,Hu Jiayan. Effects of different anesthesia methods on ischemia reperfusion injury in patients undergoing hepatectomy[J]. journal1, 2017, 24(2): 98-101.

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http://manu58.magtech.com.cn/Jwk_zgyytj/EN/10.3969/j.issn.1006-5253.2017.02.006 OR http://manu58.magtech.com.cn/Jwk_zgyytj/EN/Y2017/V24/I2/98

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