The GP and the specialist: gynaecology.
The GP and the specialist: gynaecology.
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全科医生和专科医生：妇科。
DOI：
10.1136/bmj.286.6368.890
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发表时间：
1983
期刊：
影响因子：
--
通讯作者：
John McQueen
中科院分区：
文献类型：
--
作者：
John McQueen
声称后者最终证明了氟烷与肝坏死之间的关联。事实并非如此：它确实表明，反复使用氟烷全身麻醉可能会导致少数宫颈癌患者血清丙氨酸转氨酶浓度升高。他没有提到，在国家氟烷研究中，九个不明原因的肝坏死病例中，有两个没有接受氟烷治疗。氟烷引起的暴发性肝坏死综合征与病毒性肝炎没有任何区别。有人指出，一年内大约有 4000 名处于病毒性肝炎潜伏期的人接受手术和麻醉。 2 因此，在许多手术和麻醉后发生肝衰竭的病例中，很难将病因归咎于氟烷，而实际上未怀疑的病毒性肝炎可能是病因。在国家氟烷研究中，尽管肝功能衰竭与不明原因病例的关联性较高，但在检查总体死亡率时，氟烷表现良好。氟烷的总死亡率为 1 87%，而国家氟烷研究中所有麻醉剂的平均死亡率为 1-932%。因此，尚未证明氟烷会导致肝坏死。
asserting that the latter proved conclusively the association between halothane and liver necrosis. This is not so: what it does show is that repeated general anaesthetics with halothane can produce in a small number of patients with carcinoma of the cervix a rise in serum alanine transaminase concentrations. He does not mention that in the National Halothane Study out of nine unexplained cases of hepatic necrosis two did not receive halothane. The syndrome of fulminant hepatic necrosis following halothane is indistinguishable in any way from the condition of viral hepatitis. It has been pointed out that by chance alone about 4000 people who are in the incubation phase of viral hepatitis undergo surgery and anaesthesia in a given year.2 For this reason it is difficult to assign the aetiology in many cases of hepatic failure after surgery and anaesthesia to halothane, when unsuspected viral hepatitis may actually be the cause. In the National Halothane Study, despite a higher association of hepatic failure with the unexplained cases, halothane compared well when overall death rates were examined. Halothane was attended by an overall mortality of 1 87>" compared with an average mortality for all anaesthetics in the National Halothane Study of 1-932). It has thus not been proved that halothane causes liver necrosis.