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氟哌利多、芬太尼和氯胺酮全凭静脉麻醉的临床研究——8. 超过10小时长时间手术的肝肾功能

[Clinical study on total intravenous anesthesia with droperidol, fentanyl and ketamine--8. Hepatic and renal functions following prolonged surgical operation of over 10 hours].

作者信息

Kimura F, Hashimoto Y, Shimodate Y, Hashimoto H, Ishihara H, Matsuki A

机构信息

Department of Anesthesiology, University of Hirosaki School of Medicine.

出版信息

Masui. 1991 Sep;40(9):1371-5.

PMID:1942510
Abstract

Forty-four patients were studied to evaluate their postoperative hepatic and renal functions on 2nd to 4th and 7th to 10th postoperative days as judged by serum GOT, GPT, BUN and creatinine levels. The patients were divided into two groups. Twenty two patients received total intravenous anesthesia with droperidol, fentanyl and ketamine (FK group). The remaining 22 patients were given conventional enflurane-nitrous oxide anesthesia. The two groups were comparable concerning age, body weight, sex distribution, performed operation, operation time and anesthesia time. In the total intravenous group, fluid given and urine output were significantly larger than those of the enflurane group, and the amounts of blood loss and blood given tended to be greater but insignificantly in the total intravenous group than in the enflurane group. In both groups, postoperative S-GOT levels increased significantly and those of the enflurane group were significantly higher than those of the FK group on 2nd to 4th postoperative days. In the enflurane group, postoperative S-GPT levels were significantly higher, but those of the FK group were not. S-GPT on 2nd to 4th postoperative days of the enflurane group were significantly higher than those of the FK group. As to serum BUN and creatinine, no significant differences were observed between the two groups. These data suggest that FK is much more beneficial than enflurane anesthesia to protect hepatic functions, particularly when it is applied for prolonged surgical procedures.

摘要

通过血清谷草转氨酶(GOT)、谷丙转氨酶(GPT)、尿素氮(BUN)和肌酐水平,对44例患者术后第2至4天以及第7至10天的肝肾功能进行了评估。患者被分为两组。22例患者接受了氟哌利多、芬太尼和氯胺酮的全静脉麻醉(FK组)。其余22例患者接受传统的安氟醚-氧化亚氮麻醉。两组在年龄、体重、性别分布、所行手术、手术时间和麻醉时间方面具有可比性。在全静脉麻醉组中,液体输入量和尿量明显大于安氟醚组,全静脉麻醉组的失血量和输血量倾向于比安氟醚组更多,但差异不显著。两组术后血清GOT水平均显著升高,且安氟醚组在术后第2至4天显著高于FK组。在安氟醚组中,术后血清GPT水平显著更高,但FK组则不然。安氟醚组术后第2至4天的GPT显著高于FK组。至于血清BUN和肌酐,两组之间未观察到显著差异。这些数据表明,FK在保护肝功能方面比安氟醚麻醉更有益,特别是在用于长时间手术时。

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