论文部分内容阅读
目的:探讨不同吸入性麻醉药对小儿法洛四联症术后肝功能的影响.方法:选择在体外循环下择期行法洛四联症根治术患儿30例,随机分为3组(n=10),全凭静脉全麻组(对照组);静脉复合吸入异氟醚全麻组;静脉复合吸入七氟醚全麻组;静脉复合吸入麻醉药全麻组其维持麻醉期间的静脉镇静药由吸入麻醉药代替,三组的肌松药和镇痛药品种及用量相同.三组分别于术前、术后6h、12h、24h、48h 五个时间点采集血样监测肝功能指标(包括:血ALT、AST、GGT、胆红素),结果:三组病例术中一般情况无统计学差异(P>0.05).肝功能指标:三组病例的术后 ALT、胆红素水平升高(P﹤0.05),但组间比较无统计学差异(P>0.05);三组 GGT 水平术后无显著变化(P>0.05),组间亦无差异(P>0.05);三组的术后 AST 水平升高(P﹤0.05),七氟醚组术后48hAST 水平较对照组低(P﹤0.05),余个时间点无统计学差异(P>0.05).结论:全麻体外循环下行法洛四联症根治术对患儿术后肝功能存在一定损害;异氟醚、七氟醚对小儿法洛四联症术后肝功能指标的影响无差别.“,”Objection:To discuss the influences of general anesthesia with different inhalation anesthetics on postoperative liver function of children with tetralogy of Falot.Methods:30 children with tetralogy of Falot underwent elective total correction are chosen, divided into 3 groups randomly (n=10), total intravenous anesthesia group (control group); intravenous combined with isoflurane inhalation general anesthesia group; intravenous combined with sevoflurane inhalation general anesthesia group; intravenous sedatives for anesthesia maintenance is replaced by inhalation anesthetics in groups of intravenous inhalation combination, the types and doses of muscle relaxants and narcotics are the same in three groups. Blood samples were taken from three groups at five different time points: pre-op, 6h, 12h, 24h, 48h post-op, indexes of live function are measured (including: ALT, AST, GGT,bilirubin).Results:There is no statistic difference in general conditions during surgery between three groups (P>0.05). Liver function index: postoperative ALT and bilirubin are elevated in al three groups (P﹤0.05), but there is no statistic difference between three groups (P>0.05); there is no significant changes in GGT level postoperatively in three groups (P>0.05), and there is no statistic difference between groups either (P>0.05); postoperatively AST level in al three groups are elevated (P﹤0.05), AST level in sevoflurane group is lower than the control at 48h postoperative (P﹤0.05), and no statistic difference at any other time points (P>0.05).Conclusion: Postoperative liver function can somehow be compromised by total correction of tetralogy of Falot under general anesthesia and cardiac pulmonary bypass; isoflurane, sevoflurane have similar effects on postoperative liver function index in children with tetralogy of Falot.