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医学免费论文:梗阻性黄疸患者七氟烷麻醉术后苏醒时间的临床观察
【摘要】 目的 观察梗阻性黄疸患者七氟烷麻醉术后的苏醒时间。方法 60例上腹部手术患者，ASAⅠ～ Ⅱ级，按血胆红素分为无黄疸对照组，轻度黄疸组，中度黄疸组，重度黄疸组，每组15例。其中黄疸组患者均为梗阻性黄疸。常规麻醉诱导后吸入1%～2%七氟烷，维持BIS值45，术毕即停吸七氟烷。同时记录从停药后至BIS值达到90的时间和唤醒时间。结果 黄疸组BIS值达到90的时间和唤醒时间明显大于非黄疸对照组，但黄疸轻，中，重三组之间无明显差异。结论 梗阻性黄疸患者七氟烷麻醉术后苏醒时间明显延长，胆红素水平与延长的苏醒时间无明显相关性。
【关键词】 梗阻性黄疸;七氟烷;苏醒时间
Clinical Observation of Recovery Times From Anesthesia with Sevoflurane in Obstructive Jaundice Patients
Lu Zhijie,Miao Qing,Qiu Haibo,Wang Zhenmeng,Miao Xuerong,Yu Weifeng
(Department of Anesthesiology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438,China医.学.全.在.线www.med126.com)
Abstract： Objective To observe the recovery times after sevoflurane anesthesia in obstructive jaundice patients. Methods Sixty patients(ASAⅠ-Ⅱlevel) undergoing abdominal surgery were divided into four groups according to the total bilirubin level in blood: control group without jaundice, mild jaundice group, moderate jaundice group and severe jaundice group, with 15 cases of each group. All the jaundice refer to obstructive jaundice. After conventional inducting of anesthesia, 1%-2% sevoflurane was used to maintain the BIS value of 45. At the end of the surgery, sevoflurane, the time reached BIS90 and wakeup time were recorded. Results The recovery times of patients with obstructive jaundice prolonged significantly compared with control group after sevoflurane anesthesia. However, no discrepancies were observed among the groups with different levels of bilirubin. Conclusion Recovery from anesthesia with sevoflurane was delayed in obstructive jaundice patients, but the recovery times was not correlated with the the level of bilirubin医.学.全.在.线www.med126.com.
Key words： obstructive jaundice; sevoflurane; recovery times
梗阻性黄疸患者血清内胆红素浓度增高，除了肝脏功能本身的损害以外，可能还存在脑内神经递质的改变，有报道表明阻塞性患者对吸入性麻醉药的全麻敏感性升高[1]。临床上七氟烷可能是最理想的新型吸入麻醉药[2]，其诱导和苏醒均很迅速，苏醒期也比较平稳。我们对15例非黄疸上腹部手术患者和45例梗阻性黄疸患者采用七氟烷麻醉，观察其术后苏醒时间，现将结果报告如下。
