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无创肝血流测定在麻醉监护中的应用
引用本文:唐俊,杜美华,朱俊峰,周国霞,王介非. 无创肝血流测定在麻醉监护中的应用[J]. 中国临床医学, 2010, 17(1): 111-114
作者姓名:唐俊  杜美华  朱俊峰  周国霞  王介非
作者单位:1. 上海市公共卫生临床中心麻醉科,上海,201508
2. 上海市公共卫生临床中心重症肝炎科,上海,201508
3. 上海交通大学附属第六人民医院金山分院麻醉科,上海,201500
基金项目:上海市传染病学公共卫生重点学科建设项目(08GWZ0103);;上海市卫生局课题(2006Y002)
摘    要:目的:采用无创的脉搏色素浓度测定(DDG)技术研究麻醉期间肝脏血流和代谢变化。方法:利用DDG技术测定吲哚菁绿(ICG)的代谢速率,研究10例美国麻醉医师协会麻醉风险分类ASAⅠ~Ⅱ级全身麻醉患者麻醉前后肝脏血流和排泄功能的变化。结果:麻醉诱导后ICG血浆清除率从(0.29±0.07)明显下降到(0.19±0.04)(P〈0.01);5、10、15min的滞留率相应有所增加;代谢半衰期从(2.50±0.61)min延长到(3.74±0.91)min(P%0.01)。有效肝脏血流量和心脏指数均有所下降,分别从(1.41±0.40)L·min^-1。下降到(0.95±0.20)L·min^-1(P〈0.05)和从(4.07±1.08)L·min^-1·m^-2下降到(2.47±0.69)L·min^-1·m。(P〈0.01)。结论:麻醉能够减少肝脏血流,并降低ICG的排泄率。

关 键 词:全身麻醉  吲哚菁绿  肝血流

Non-invasive Monitoring of Hepatic Blood Flow in Anesthesia Practice
TANG Jun,DU Meihua,ZHU Junfeng,ZHOU Guoxia,WANG Jiefei. Non-invasive Monitoring of Hepatic Blood Flow in Anesthesia Practice[J]. Chinese Journal Of Clinical Medicine, 2010, 17(1): 111-114
Authors:TANG Jun  DU Meihua  ZHU Junfeng  ZHOU Guoxia  WANG Jiefei
Affiliation:TANG Jun1 DU Meihua1 ZHU Junfeng2 ZHOU Guoxia1 WANG Jiefei1 1.Department of Anesthesiology,ICU of Hepatitis,Shanghai Public Health Clinic Center,Fudan University,Shanghai 201508,China,2.Department of Anesthesiology,Jinshan Central Hospital,Shanghai 201500
Abstract:Objective:To study the changes of effective hepatic blood flow (EHBF) and liver excretory function during general anesthesia by Pulse Dye Densito Graph Analyzer (DDG). Methods: There were 10 American Society of Anesthesiology (ASA) Ⅰ to Ⅱ patients who underwent general anesthesia in the experiment. The liver function was studied with the non-invasive indo- eyanine green (ICG) clearance test. Results: After induction, ICG disappearance rate (K) decreased from 0.29 ± 0.07 to 0.19 ± 0.04 (P〈0.01), while the ICG retention rate 5, 10, 15 rain after ICG injection all augmented. And half time (T1/2) pro- longed from 2.50 ± 0.61 rain to 3.74 ± 0.91min (P〈0.01). EHBF and Cardiac Index (CI) decreased respectively from 1.41 ± 0.40 L·min^-1 to 0.95 ±0.20 L·min^-1 (P〈0.05), and 4.07 ± 1.08L·min^-1·m2 to 2.47 ± 0.69 L·min^-1. m2 (P〈0. 01 ). Conclusions: General anesthesia can decrease the ICG clearate and the effective hepatic blood flow.
Keywords:General Anesthesia  Indocyanine green  Liver blood flow  
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