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乙型病毒性肝炎肝硬化患者肝功能状况对靶控输注瑞芬太尼药物半衰期和镇痛效果的影响
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| 篇名： | 乙型病毒性肝炎肝硬化患者肝功能状况对靶控输注瑞芬太尼药物半衰期和镇痛效果的影响 |
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| 摘要： | 目的：探讨乙型病毒性肝炎（以下简称“乙肝”）肝硬化患者的肝功能状况对靶控输注瑞芬太尼药物半衰期和镇痛效果的影响及安全性。方法：选择我院确诊为乙肝肝硬化并拟在全身麻醉下行肝胆手术的患者100例，根据患者肝功能 Child-Pugh 分级分为肝功能轻度异常的A组50例和肝功能严重异常的B组50例（3例病例脱落，共47例完成研究）。两组患者均于术前0.5 h给予苯巴比妥钠0.1 g+东莨菪碱注射液0.3 mg，肌内注射；咪达唑仑0.04 mg/kg+丙泊酚1.5 mg/kg+阿曲库铵0.6 mg/kg，静脉注射；术中给予注射用盐酸瑞芬太尼0.125～0.250 μg/（kg·min）静脉靶控输注。测定两组患者的瑞芬太尼药物分布半衰期和消除半衰期，术后即刻分别测量温度疼痛感知阈（tPDT）和电疼痛感知阈（ePDT），并观察其不良反应发生情况。结果：A组患者芬太尼药物分布半衰期和消除半衰期分别为（4.52±1.25）min和（24.64±1.30）min，B组患者为（4.68±1.31）min和（25.45±2.08）min，组间比较差异无统计学意义（P＞0.05）；A组患者tPDT和ePDT分别为（8.88±1.66）mA和（1.54±0.09）mA，B组患者分别为（9.16±1.58）mA和（1.34±0.15）mA，组间比较差异均无统计学意义（P＞0.05）。两组患者均未见明显不良反应发生。结论：乙肝肝硬化患者肝功能异常状况对瑞芬太尼的药物半衰期和镇痛效果无明显影响，且安全性均较好。 |
| ABSTRACT： | OBJECTIVE： To explore the safety and effects of liver function in patients with liver cirrhosis following virus B hepatitis （called “hepatitis B” for short） on drug half-life and analgesic effect of target controlled infusion of remifentanil. METHODS： 100 patients with liver cirrhosis following hepatitis B underwent liver and gallbladder surgery under selective general anesthesia were collected from our hospital and divided into group A （mild abnormal liver function） and group B （severe abnormal liver function， 3 cases withdrew from the test and 47 cases completed the test）， with 50 cases in each group， according to Child-Pugh grading of liver function. Both group were given phenobarbital sodium 0.1 g+scopolamine 0.3 mg intramuscularly 0.5 h before operation； midazolam 0.04 mg/kg+propofol 1.5 mg/kg+atracurium 0.6 mg/kg intravenously； target controlled infusion of Remifentanil hydrochloride for injection during operation with 0.125-0.250 μg/（kg·min）. The distribution half-life and the elimination half-life of remifentanil were determined， and temperature pain perception threshold （tPDT） and electrical pain perception threshold （ePDT） were measured immediately after the operation； the occurrence of ADR was observed. RESULTS： The distribution and elimination half-life of remifentanil were （4.52±1.25）min and（24.64±1.30）min in group A and （4.68±1.31）min and（25.45±2.08）min in group B respectively， there was no statistical significance between 2 groups （P＞0.05）. tPDT and ePDT of group A were （8.88±1.66）mA and （1.54±0.09）mA respectively， and those of group B were （9.16±1.58）mA and （1.34±0.15） mA， there was no statistical significance between 2 groups （P＞0.05）. No obvious ADR was found in 2 groups. CONCLUSIONS： The abnormal liver function of patients with liver cirrhosis following hepatitis B have no significant effect on drug half-life and analgesic effect of remifentanil with good safety. |
| 期刊： | 2016年第27卷第20期 |
| 作者： | 李晓宁，张卫 |
| AUTHORS： | LI Xiaoning，ZHANG Wei |
| 关键字： | 乙型病毒性肝炎；肝硬化；肝功能；瑞芬太尼；药物半衰期；镇痛效果 |
| KEYWORDS： | Virus B hepatitis； Liver cirrhosis； Liver function； Remifentanil； Drug half life； Analgesia effect |
| 阅读数： | 291 次 |
| 本月下载数： | 2 次 |
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