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地氟醚对体循环和肝脏血液动力学的影响 |
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李士通 庄心良 徐国辉 陆惟俊 陈武荣
摘 要 目的：探讨地氟醚对全身和肝血液动力学及氧代谢的影响。方法：犬11只吸入地氟醚0.5MAC(3%)和1.0MAC(6%)，连续监测体循环、肺循环、肝动脉、门静脉血液动力学和全身氧供需平衡及肝氧供。肝血流用电磁血流仪监测。结果：吸入0.5MAC使心率(HR)、平均动脉压(MAP)、外周血管阻力(SVR)、门静脉氧供和肝脏总氧供显著下降(P＜0.01)，门静脉血流下降、心搏量升高(P＜0.05)；1.0MAC后HR、MAP、SVR进一步下降(P＜0.01)，肺动脉压、门静脉压降低(P＜0.05)，肝动脉阻力也下降(P＜0.05)；吸入地氟醚期间心排血量、肝动脉血流量、全身氧供、氧耗、氧储备和肝动脉氧供保持平稳(P＞0.05)。结论：吸入1.0MAC以下时地氟醚时全身和肝脏血液动力学和氧供需平衡无明显紊乱。
关键词 地氟醚 肝脏 血液动力学 氧耗
Effects of desflurane on canine systemic
and hepatic hemodynamics
Li Shitong，Zhuang Xinliang，Xu Guohei，et al．Department of Anesthesiology，Shanghai First Peoples Hospital，Shanghai 200080
Abstract Objective：To explore the effects of desflurane on systemic and hepatic hemodynamics and oxygen delivery to the liver.Method：11 healthy mongrel dogs were anesthetized with 0．5 and 1．0 MAC desflurane respectively．The changes of systemic，pulmonary and hepatic hemodynamics，systemic oxgen delivery and consumption，oxygen delivery to the liver were measured continuously．Blood flow of
hepatic artery and portal vein was monitored with electromagnetic flowmeter． Result：During inhalation of 0．5 MAC desflurane，HR，MAP，SVR，portal vein and total hepatic oxygen delivery decreased significantly(P＜0.01）．Portal vein blood flow decreased and SV increased（P＜0.05）．At 1．0 MAC， HR，MAP and SVR decreased further more（P＜0.01），mean pulmonary artery pressure and portal vein pressure decreased(P＜0.05），vascular resistance of hepatic artery decreased (P＜0.05）．CO，systemic oxygen delivery and consumption，hepatic artery blood flow and oxygen delivery remained stable in either 0．5 or 1．0MAC desflurane inhalation．Conclusion：Desflurane at less than 1．0MAC is no significant harm to systemic and hepatic hemodynamics and oxygen delivery-consumption balance．
Key word Desflurane Liver Hemodynamics Oxygen consumption
卤素吸入麻醉药的肝损害常与术中肝细胞缺血缺氧有关，地氟醚是新的吸入麻醉药，对肝循环和氧供的影响值得探讨。本研究旨在观察应用0.5MAC和1.0MAC地氟醚吸入麻醉时全身血液动力学和氧供需平衡以及肝脏血[1] [2] 下一页
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