不同时程七氟烷吸入对肝脏部分切除术患者肝脏缺血再灌注损伤的影响

吴言悟; 蔡畅

doi:10.16766/j.cnki.issn.1674-4152.000303

不同时程七氟烷吸入对肝脏部分切除术患者肝脏缺血再灌注损伤的影响

doi: 10.16766/j.cnki.issn.1674-4152.000303

吴言悟^,,
蔡畅

宁波市医疗中心李惠利东部医院麻醉科, 浙江宁波 315000

基金项目:

2017年浙江省医学会临床科研基金项目(2017ZYC-A49)

详细信息

通讯作者:
吴言悟,E-mail:1678968337@qq.com

中图分类号: R614.2;R657.3
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出版历程
- 收稿日期: 2018-01-20
- 网络出版日期: 2022-08-05

Effect of Sevoflurane inhalation in different time course on liver ischemia reperfusion injury in patients with partial liver resection

WU Yan-wu^,,
CAI Chang

Department of Anesthesiology, Lihuili Eastern Hospital, Ningbo, Zhejiang 315000, China

摘要

摘要: 目的探讨不同时程七氟烷吸入对肝脏部分切除术患者肝脏缺血再灌注损伤的影响。方法将宁波市医疗中心李惠利东部医院2016年1月-2017年12月收治的择期行肝脏部分切除术患者90例按不同时程七氟烷处理分为七氟烷预处理组、七氟烷后处理组、七氟烷全程吸入组,每组30例。在术前(T0)、结束时(T1)、术后24 h(T2),术后3 d(T3)、术后5 d(T4)、术后8 d(T5)采取患者心静脉血,对其ALT、AST、SOD、MDA、IL-6、IL-10、TNF-α进行检测,并记录阻断次数、阻断时间、出血量、术后住院时间。结果七氟烷预处理组T2、T3、T4、T5各个时间点ALT、AST、IL-6、TNF-α、IL-10及SOD水平较七氟烷后处理组、七氟烷全程吸入组升高(均P<0.05);七氟烷全程吸入组T2、T3、T4、T5各个时间点ALT、AST、IL-6、TNF-α水平较七氟烷后处理组降低(均P<0.05);七氟烷后处理组T2、T3、T4、T5各个时间点IL-10、SOD水平较七氟烷全程吸入组降低(均P<0.05);七氟烷预处理组T2、T3、T4、T5各个时间点MDA水平较七氟烷后处理组、七氟烷全程吸入组降低(均P<0.05);七氟烷全程吸入组T2、T3、T4、T5各个时间点MDA水平较七氟烷后处理组降低(均P<0.05)。结论七氟烷预处理可显著减轻肝脏部分切除术患者肝脏缺血再灌注损伤,可能是通过对IL-6、TNF-α的激活和释放进行抑制,从而抑制氧自由基的生成和脂质过氧化,激活和释放IL-10,减少肝脏器官与组织的损伤。
- 不同时程 /
- 七氟烷吸入 /
- 肝脏部分切除 /
- 肝脏缺血再灌注损伤
Abstract: Objective To investigate the effect of Sevoflurane inhalation in different time history on liver ischemia-reperfusion injury in patients with partial liver resection. Methods Ninety cases of partial hepatectomy in our hospital from January, 2016 to December, 2017 were divided into Sevoflurane pre-treatment group, Sevoflurane after-treatment group and Sevoflurane whole course inhalation group, with 30 cases in each group. Blood samples were taken at preoperative (T0), end (T1), postoperative 24 h (T2), postoperative 3 D (T3), and postoperative 5 D (T4) and postoperative 8 D (T5). Serum SOD, MDA, IL-6, IL-10 and TNF-alpha were detected, and the number of interruption, blocking time, bleeding volume and postoperative hospitalization time were recorded. Results ALT, AST, IL-6, TNF-alpha, IL-10 and SOD levels of pre-treatment group at different time points of T2, T3, T4 and T5 were higher than those of after-treatment group and while course inhalation group (P<0.05); ALT, AST, IL-6 and TNF-alpha levels of after-treatment group at different time points of T2, T3, T4 and T5 were lower than those of while course inhalation group (P<0.05); IL-10 and SOD levels of while course inhalation group at different time points of T2, T3, T4 and T5 were lower than those of after-treatment group (P<0.05). MDA levels of pre-treatment group at different time points of T2, T3, T4 and T5 were lower than those of after-treatment group and while course inhalation group (P<0.05); MDA levels of while course inhalation group at different time points of T2, T3, T4 and T5 were lower than those of after-treatment group (P<0.05). Conclusion The Sevoflurane pre-treatment can reduce hepatic ischemia reperfusion injury in patients with liver resection, probably through the IL-6 and TNF- alpha activation and release to inhibit the production of free radicals and lipid peroxidation, activate and release IL-10, and reduce the liver organ and tissue damage.
- Different time course /
- Sevoflurane inhalation /
- Partial resection of the liver /
- Hepatic ischemia-reperfusion injury