胃がん手術後の急性腎臓損傷に対するセボフルラン基またはプロポフール基麻酔の効果: 後向きの傾向スコアマッチ分析
Yang Song1, Si Liang2,3, Ming Wei1
1Department of Anesthesiology, Harbin Medical University Cancer Hospital, No. 150 Haping Rd., Nangang District, Harbin, 150081, China.
BMC anesthesiology
|August 27, 2025
まとめ
この研究では,プロポフォールベースの全静脈麻酔 (TIVA) とセボフルランベースの吸入麻酔 (INHA) を比較したところ,胃がん手術後の急性腎臓損傷 (AKI) 率に有意な差は認められなかった. 両方の麻酔方法は,手術後の腎臓機能に関する同様の安全性プロファイルを示した.
科学分野:
- 麻酔科
- 腎臓科
- 手術腫瘍学
背景:
- 急性腎損傷 (AKI) は,大きな腹部手術,特に胃がん手術後の重大な合併症です.
- AKIは患者の死亡率と有害な結果の増加と関連しています.
- AKIのリスクを軽減する麻酔の戦略を特定することは,手術結果を改善するために極めて重要です.
研究 の 目的:
- 胃がん手術を受けた患者の術後のAKIの発生率を比較する.
- AKIに関するセボフルーランベースの吸入麻酔 (INHA) と対比してプロポフォールベースの全麻酔 (TIVA) の安全性を評価する.
- この患者集団における麻酔薬の選択が AKI 率に影響するかどうかを判断する.
主な方法:
- ハルビン医科大学がん病院 (2010年−2018年) の胃がん手術患者の医療記録の遡及分析.
- 比較可能なグループを作成するために,傾向スコアのマッチングが採用されました.
- プロポフォールTIVAとセボフルランINHA群の間で,最初の3日間のAKIの発生率を比較した.
主要な成果:
- 最初,合計3533人の患者が対象となり,1206人が麻酔用グループにマッチングされた.
- ロジスティック回帰では,プロポフロールとセボフルーランのグループ間のAKI発生率において,マッチング前 (OR1. 05) とマッチング後 (OR1. 02) の両方で有意な差異は見られなかった.
- 比較後のAKIの発生率はセボフルランの5. 0%,プロポフールの5. 1%で,比較可能な割合を示しています.
結論:
- 胃切除術後のAKIの統計的に有意な差は示されていない.
- プロポフォール基のTIVAとセボフルラン基のINHAは,胃がん手術の患者におけるAKIリスクに関して,類似した安全性プロファイルを持っているようです.
- プロポフォールとセボフルーランの間の麻酔の選択は,胃切除術後のAKIの発症の可能性に有意な影響を与えない.
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