两种不同麻醉方式对肝癌手术患者肝功能影响的比较
Comparison of the Effects of two Different Anesthetic Techniques on Liver Function in Patients Undergoing Liver Cancer
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摘要: 目的观察比较静吸复合全麻和硬膜外联合静脉麻醉对肝癌手术患者肝功能的影响。方法选择ASAⅠ～Ⅱ级ChildPugh分类为A级的肝叶切除患者30例,随机分为联合组,对照组各15例。联合组于T8～9穿刺置管,注入0.2%罗呱卡因5ml确定麻醉平面后,行气管插管,之后每小时硬腹外导管推注0.2%罗呱卡因5～7ml,直至术毕。同时将异丙酚200mg+瑞芬太尼0.2mg合剂以异丙酚40～60μg/(kg·min)-1输注。对照组持续吸入异氟醚间断静注芬太尼。两组患者于入室后(d0)、术后第1天(d1)、第3天(d2)、第5天(d3)、和第7天(d4)做肝功能的测定。入室(t0)、阻断肝门(t1)、恢复肝血流(t2)、恢复肝血流后1小时(t3)、术毕(t4)监测血流动力学。结果1.术毕联合组睁眼时间、自主呼吸恢复时间、拔管时间均明显低于对照组,清醒程度明显优于对照组(P<0.01)。2.两组ALT、ASTd1时两组均极显著上升(P<0.01),但联合组明显低于对照组(P<0.01)。d2～d3时联合组恢复正常,而对照组至d4时恢复正常。两组TBIL在d1开始升高,联合组明显低于对照组(P<0.05)。d4时均恢复正常。3....Abstract: Objective To observe and compare the effects of inhalational combined intravenous anesthesia and epidural general anesthesia on liver function in patients undergoing liver cancer. Methods 30 patients with ASA status Ⅰ～Ⅱ Child-pugh A undergoing hepatolobectomy were randomly divided into two groups: group Ⅰ,united group (n=15); group Ⅱ, control group (n=15). Patients in group ⅠT_ 8～9 were exposed to 0.2% ropivacaine 5ml until testing satisfied. Then followed tracheal intubation, and thetotal is 10ml. Patients...
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