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本公眾號每天分享一篇最新一期Anesthesia & Analgesia等SCI雜志的摘要翻譯,，敬請關注并提出寶貴意見 Impact of Volatile Anesthetic Agents on Early Clinical Outcomes in Liver Transplantation 背景與目的 很少有研究報道吸入麻醉藥對肝移植術后缺血再灌注損傷（IRI）中的影響,。本研究擬對2001和2015之間所有肝移植（LT）器官受者和器官捐贈者的數(shù)據(jù)進行單中心回顧性分析，比較吸入性麻醉藥對早期肝移植患者IRI的影響,。 方 法 對2001和2015之間所有LT器官受者和器官捐贈者的數(shù)據(jù)進行單中心回顧性分析,。基礎麻醉藥是由麻醉醫(yī)師自行決定的,。在術后每天對血清丙氨酸轉氨酶（ALT）和總膽紅素（TB）水平進行測量以作為評估早期移植損傷和功能恢復的措施,。記錄存活率和臨床結局,。 結 果 本研究共納入1291例LT患者，3中主要吸入麻醉藥：異氟醚（62%）,、地氟醚（8%）和七氟醚（30%）,。在移植后第7天，ALT峰值在地氟醚組最低（352）,，其次是七氟醚組（411）和異氟烷組（481）（P＝.09）。移植后第7天各組ALT和TB水平相似,。移植存活率各組在1,、7、30d統(tǒng)計學相似,，1年內各組患者移植存活率相當,。 結 論 3種藥物移植早期發(fā)生肝功能異常和腎功能異常的率相同。高危供體移植物的亞組分析差異無統(tǒng)計學意義,。綜上所述,，地氟醚或七氟醚可以對IRI后肝功能的早期保護有一定作用，但其長期結局和其他吸入麻醉藥相當,。 原始文獻摘要 Mangus RS1, Kinsella SB2, Farar DT2, Fridell JA3, Woolf LT2, Kubal CA3. Impact of Volatile Anesthetic Agents on Early Clinical Outcomes in Liver Transplantation.Transplant Proc. 2018 Jun;50(5):1372-1377. doi: 10.1016/j.transproceed.2018.03.001. ABSTRACT Background：Few studies have assessed the ability of inhaled anesthetic agents to ameliorate ischemia-reperfusion injury (IRI) in liver transplantation (LT). This study compares inhaled anesthetics in early liver allograft IRI. LT recipient and organ donor data were extracted retrospectively for all LTs at a single center between 2001 and 2015. Methods：LT recipient and organ donor data were extracted retrospectively for all LTs at a single center between 2001 and 2015. The choice of primary anesthetic agent was at the discretion of the anesthesiologist. Serum alanine aminotransferase (ALT) and total bilirubin (TB) levels were measured daily in the post-transplant period as measures of early graft injury and function. Survival and clinical outcomes are reported. Results：There were 1291 primary LTs included in the analysis, with 3 primary inhaled agents: isoflurane (62%), desflurane (8%), and sevoflurane (30%). In the first 7 days posttransplant, the peak ALT level was lowest for desflurane (352), followed by sevoflurane (411) and isoflurane (481) (P =.09). All groups had similar ALT and TB by 7 days post-transplant. Graft survival for all 3 groups was statistically similar at 1, 7, and 30 days, with equivalent patient and graft survival at 1 year. Conclusions： All 3 agents had similar rates of early allograft dysfunction and renal dysfunction. Subgroup analysis of high-risk donor grafts showed no statistical difference. In conclusion, administration of desflurane or sevoflurane may provide some early hepatoprotection against IRI, but longer-term outcomes were equivalent for all agents. 麻醉學文獻進展分享 |
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來自： 罌粟花anesthGH > 《待分類》
