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[异氟烷麻醉对腹部外科手术患者内分泌反应模式的影响]

[Endocrine reaction pattern in abdominal surgical patients as affected by isoflurane anesthesia].

作者信息

Seitz W, Bechstein W, Onken G, Fritz K, Kirchner E

出版信息

Anaesthesist. 1985 Sep;34(9):451-5.

PMID:4083467
Abstract

The effects of isoflurane anaesthesia on the per- and postoperative change in blood concentrations of aldosterone, cortisol, dehydroepiandrosterone, insulin, prolactin, thyroxine, t3-uptake, epinephrine, norepinephrine, dopamine, glucose, FFS, lactate, and pyruvate were investigated in connection with major abdominal surgery. Contrary to prolactin levels (8.42 +/- 1.71 ng/ml----46.25 +/- 6.78 ng/ml; p less than 0.001) the plasma concentrations of the adrenal steroids aldosterone, cortisol, and dehydroepiandrosterone sank initially after induction of anaesthesia with thiopentone. However, after skin incision the levels of aldosterone (49.9 +/- 11.6 pg/ml----202.1 +/- 57.6 pg/ml; p less than 0.01), cortisol (16.7 +/- 2.57 ng/dl----25.2 +/- 3.72 ng/dl; p less than 0.01) and DHEA (2.70 +/- 0.99 ng/ml----5.02 +/- 1.03 ng/ml; p less than 0.05) rose significantly. Generally, plasma insulin was not markedly influenced by isoflurane anaesthesia and surgery. No significant alterations in plasma catecholamine concentrations were observed.

摘要

研究了异氟烷麻醉对大腹部手术围手术期和术后醛固酮、皮质醇、脱氢表雄酮、胰岛素、催乳素、甲状腺素、T3摄取、肾上腺素、去甲肾上腺素、多巴胺、葡萄糖、游离脂肪酸、乳酸和丙酮酸血药浓度变化的影响。与催乳素水平(8.42±1.71 ng/ml ---- 46.25±6.78 ng/ml;p<0.001)相反,硫喷妥钠麻醉诱导后,肾上腺类固醇醛固酮、皮质醇和脱氢表雄酮的血浆浓度最初下降。然而,皮肤切开后,醛固酮(49.9±11.6 pg/ml ---- 202.1±57.6 pg/ml;p<0.01)、皮质醇(16.7±2.57 ng/dl ---- 25.2±3.72 ng/dl;p<0.01)和脱氢表雄酮(2.70±0.99 ng/ml ---- 5.02±1.03 ng/ml;p<0.05)的水平显著升高。一般来说,血浆胰岛素不受异氟烷麻醉和手术的明显影响。未观察到血浆儿茶酚胺浓度有显著变化。

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