肝病患者的术前处理相当复杂,因为不但肝脏参与许多代谢与合成过程,而且肝病会影响许多肝脏功能,术前处理时要考虑肝脏的多种功能以及病理生理过程中会引起的合并症。麻醉与手术对肝脏的影响大多数在全身麻醉、腰麻或硬脊膜外麻醉下进行的外科手术会引起肝脏的血生化检验改变。一般表现为血清转氨酶、硷性磷酸酶和胆红素浓度的轻度、暂时性升高,无明显的临床意义。除了氯仿以外,其他的麻醉药物对肝脏均无直接的毒害作用。但是,所有的麻醉剂,包括在腰麻和硬脊膜外麻醉中使用的药物均会 Preoperative management of patients with liver disease is quite complex, because not only the liver involved in many metabolic and synthetic processes, and liver disease will affect many liver functions, preoperative treatment to consider a variety of liver functions and pathophysiology can cause complications. Effects of Anesthesia and Surgery on the Liver Most surgical procedures performed under general anesthesia, spinal anesthesia, or epidural anesthesia can cause changes in the blood chemistry of the liver. The general performance of serum aminotransferase, alkaline phosphatase and bilirubin concentrations of mild, temporary increase, no significant clinical significance. Apart from chloroform, other narcotic drugs have no direct toxic effect on the liver. However, all anesthetics, including those used in spinal anesthesia and epidural anesthesia, will