低流量七氟醚麻醉和全静脉麻醉对肝肾功能的影响

目的探讨中等时长的低流量七氟醚麻醉和全静脉麻醉（TIVA）对肝肾功能的影响。方法 100例预期手术时长120~240 min择期行腰椎间盘手术的患者,随机分为七氟醚麻醉组（S组）和TIVA组（T组）,各50例。测定术前和术后24h4、8 h、72 h血清尿素氮（BUN）、肌酐（Scr）、丙氨酸转移酶（ALT）、天冬氨酸转移酶（AST）、乳酸脱氢酶（LDH）和24 h尿糖、尿蛋白和尿肌酐（Ucr）水平。结果 2组患者血清AST、ALT和LDH术前与术后无明显变化。S组患者术后48 h的血清BUN,24 h和48 h的尿糖均较术前有所升高,而术后24 h和48 h的Scr较术前显著升高,但均与T组无显著差异。2组术后Ucr均较术前明显升高,但2组间无显著差异。结论中等时长的低流量七氟醚麻醉与TIVA患者的肝肾功能的影响是相似的。

Effects of low-flow sevoflurane anesthesia and total intravenous anesthesia on hepatic and renal functions

Objective To explore the effects of moderate duration lowflow sevoflurane versus total intravenous anesthesia（TIVA） on renal and hepatic functions.Methods One hundred patients who were scheduled for elective lumbar disc operation with an expected operation time between 120 min to 240 min were randomly assigned into two groups： sevoflurane anesthesia group （group S,n=50） and TIVA group（group T,n=50）.Serum urea nitrogen（BUN）,creatinine（Scr）,serum alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,lactate dehydrogenase（LDH） and 24 h excretion of glucose,protein, and urine creatinine（Ucr） were measured.Results Serum AST,ALT and LDH at 24 h,48 h and 72 h in the two groups had no obvious changes.Serum BUN at 48 h,urine glucose at 24 h and 48 h were slightly higher than the preoperative values in Group S.Scr at 24 h and 48 h were obviously higher than the preoperative values in Group S,but there was no significant difference between the groups.Ucr after operation in the two groups were obviously higher than preoperative values,but there was no significant difference between the groups.Conclusion The effects of moderate duration low-flow sevoflurane on the renal and hepatic functions are positively similar to TIVA.