Trowell J, Peto R, Smith A C
Lancet. 1975 Apr 12;1(7911):821-4.
39 patients with carcinoma of the uterine cervix who were treated with radium and required repeated general anaesthetics were randomised to halothane and control groups. Their serum-alanine-aminotransferase (S.G.P.T.) levels were measured before each general anaesthetic, and those patients whose S.G.P.T. levels rose above 100 I.U. per litre were freed from the restriction determined by the initial allocation and treated as indicated clinically. None of the 21 patients in the control group had S.G.P.T. levels rising above 100 I.U. per litre. 4 out of 18 patients in the halothane group developed S.G.P.T. levels above 100 i.u. per litre before their third radium treatment. None of these had any symptoms or alteration in other liver-function tests, but liver biopsies in 2 of these patients showed changes characteristic of Hepatitis. Arbitrary selection of 18 out of the 39 patients would only give rise to the degree of abnormality observed in the halothane-treated group with a probability of about 0-02. In the patients studied who required repeated general anaesthetics at short time intervals, the monitoring of S.G.P.T. levels before each operation was useful screen for liver damage and may have reduced postoperative hepatic necrosis by preventing further anaesthetics with halothane when the liver was already damaged.
39例接受镭疗且需要多次全身麻醉的宫颈癌患者被随机分为氟烷组和对照组。在每次全身麻醉前测量她们的血清谷丙转氨酶（S.G.P.T.）水平，那些S.G.P.T.水平升至每升100国际单位以上的患者不受初始分组限制，按临床指征进行治疗。对照组的21例患者中，无一例S.G.P.T.水平升至每升100国际单位以上。氟烷组的18例患者中有4例在第三次镭疗前S.G.P.T.水平升至每升100国际单位以上。这些患者均无任何症状或其他肝功能检查异常，但其中2例患者的肝活检显示有肝炎特征性改变。在这39例患者中任意选取18例，出现氟烷治疗组中观察到的异常程度的概率仅约为0.02。在研究中那些需要在短时间间隔内多次接受全身麻醉的患者中，每次手术前监测S.G.P.T.水平对肝损伤是一种有用的筛查方法，并且通过在肝脏已受损时避免再次使用氟烷麻醉，可能减少了术后肝坏死的发生。
