Moult P J, Sherlock S
Q J Med. 1975 Jan;44(173):99-114.
Twenty-six patients are described who had otherwise unexplained hepatitis after halothane anaesthesia. Twenty-four (92 per cent) had multiple exposures, and 11 (42 per cent) died. In eight patients a characteristic pattern of delayed postoperative pyrexia has been found. Obesity was common, but the clinical features and complications were those of any severe hepatitis. Obesity, early onset of jaundice after anaesthesia, and low thrombotest, were associated with a fatal outcome. None of those who were followed up after recovery developed clinical or biochemical evidence of chronic liver disease. The differential diagnosis of postoperative jaundice is discussed, and it is shown that halothane patients with hepatic encephalopathy are significantly older (25.4 plus or minus 11.6 years) than those referred to this unit with viral hepatitis of equal severity (34.1 plus or minus 16.4 years). Unexplained jaundice or delayed pyrexia after a previous administration of halothane should be a contraindication to its further use.
本文描述了26例在氟烷麻醉后出现不明原因肝炎的患者。其中24例（92%）有多次接触氟烷史，11例（42%）死亡。在8例患者中发现了术后延迟发热的特征性模式。肥胖较为常见，但临床特征和并发症与任何严重肝炎相同。肥胖、麻醉后黄疸早发及凝血酶原时间缩短与致命结局相关。康复后接受随访的患者均未出现慢性肝病的临床或生化证据。文中讨论了术后黄疸的鉴别诊断，结果显示，发生肝性脑病的氟烷患者（25.4±11.6岁）比因同等严重程度的病毒性肝炎转诊至本单位的患者（34.1±16.4岁）年龄明显偏大。既往使用氟烷后出现不明原因黄疸或延迟发热应作为再次使用氟烷的禁忌证。
