Abstract：【Objective】To investigate the effect of sevoflurane on elderly laparoscopic gallbladder resection (LC) perioperative inflammatory reaction and respiratory dynamic function effect. 【Methods】One hundred and thirty cases of elderly patients taking LC surgical were retrospectively analyzed. The sample set included 69 patients who used sevoflurane anesthesia (sevoflurane group) and 61 patients who used propofol anesthesia (propofol group). Respiratory function index like tidal volume (VT), airway pressure (Paw), peak airway pressure (Ppeak), airway pressure (Pplat) and chest compliance (Compl) were measured at different time points T1 (before anesthesia), T2(after pneumoperitoneum), T3(30 minutes after surgery) and T4(pneumoperitoneum ending). The peri- and post-operative serum inflammatory factor levels (IL-6, TNF-α,IL-10 and CRP) were monitored and compared between the two groups. 【Results】At T1 and T4, the VT, Paw, Ppeak, Pplat, and Compl levels were not statistically different between the sevoflurane and propofol group patients (P>0.05). At T2 and T3, the VT and Compl values were significantly higher in the sevoflurane group than in the propfol group (P<0.05). The Paw value, however, was lower in the sevoflurane group than in the propofol group (P<0.05). Before induction of anesthesia, the IL-6, TNF-α, IL-10, and CRP level were not significantly different between the sevoflurane group and the propofol group (P>0.05). Twenty four hours after operation, the IL-6, TNF-α, IL-10, and C-reactive protein (CRP) levels significantly lower in the sevoflurane group than in the propofol group (P<0.05). 【Conclusion】Sevoflurane has little effect on the elderly LC perioperative respiratory function, however, it does reduce inflammation after operation.
朱宏玮,刘颖,朱建君. 七氟醚对老年人腹腔镜胆囊切除术患者围术期炎症反应和呼吸动力功能的影响[J]. 医学临床研究, 2016, 33(11): 2125-2127.
ZHU Hong-wei, LIU Ying, ZHU Jian-jun. Sevoflurane for Laparoscopic Cholecystectomy in Elderly Patients with Inflammatory Reaction on Respiratory Function and Operative Effect Analysis. JOURNAL OF CLINICAL RESEARCH, 2016, 33(11): 2125-2127.
[1] 王东, 方聪友, 涂元茂,等. 两孔法腹腔镜胆囊切除术40例体会[J].中华普外科手术学杂志:电子版, 2014,5(2):61-63. [2] 徐匹夫,余后火.腹腔镜胆总管切开胆道镜取石T管引流术与开腹手术治疗结石效果比较[J].现代仪器与医疗,2014,20(3):100-102. [3] Joseph M, Phillips MR, Farrell TM,et al.Single incision laparoscopic cholecystectomy is associated with a higher bile duct injury rate: a review and a word of caution[J].Ann Surg,2015, 261(2):1-6. [4] Gurusamy KS, Samraj K, Davidson BR. Low pressure versus standard pressure pneumoperitoneum in laparoscopic cholecystectomy[J].Cochrane Database Syst Rev2014, 3(3): 693-693. [5] 陈华, 邵文廷, 郑长才,等. 腹腔镜胆囊切除术胆管损伤9例临床分析[J].中华全科医学, 2014, 12(7):1168-1170. [6] Boni L, Fingerhut A. Toward 0% Bile Duct Injury During Laparoscopic Cholecystectomy[J].Surgical Endoscopy,2016, 14(7):608-611. [7] 李坤平, 方永平, 廖锦岐,等. Child分级、MELD评分系统在胆囊炎合并肝硬化患者行腹腔镜胆囊切除术中的应用评价[J].中华肝胆外科杂志, 2014, 20(3):114-116. [8] Movassaghi R, Peirovifar A, Aghamohammadi D,et al.Premedication with single dose of acetazolamide for the control of referral shoulder pain after laparoscopic cholecystectomy[J].Anesthesiol Pain Med,2015, 5(6):44-48. [9] Murata A, Okamoto K, Muramatsu K,et al.Effects of additional laparoscopic cholecystectomy on outcomes of laparoscopic gastrectomy in patients with gastric cancer based on a national administrative database[J].J Surg Res,2014, 186(1):157-163. [10] 张辉. 肿瘤全麻手术依托咪酯与七氟醚诱导对血流动力学的影响比较[J].中华肿瘤防治杂志, 2015,15(11):222-223.
2016, Vol. 33 
