發(fā)布時(shí)間：2018-12-14 15:28

【摘要】：目的:探討門冬氨酸鳥氨酸對肝部分切除術(shù)后缺血再灌注損傷的保護(hù)作用。方法:選取肝部分切除術(shù)患者104例(均行肝門區(qū)域血管阻斷),按隨機(jī)數(shù)字表法分為對照組53例和試驗(yàn)組51例。對照組患者給予常規(guī)保肝藥物,試驗(yàn)組患者在對照組基礎(chǔ)上再予門冬氨酸鳥氨酸10 g加入5%葡萄糖注射液250 ml中靜脈滴注,于術(shù)前開始應(yīng)用,連續(xù)用藥7 d。兩組患者分別于術(shù)前第1天和術(shù)后第1、4、6天清晨空腹抽外周靜脈血檢測肝功能并進(jìn)行比較,同時(shí)對不同肝門阻斷時(shí)間下兩組患者術(shù)后主要轉(zhuǎn)氨酶指標(biāo)[丙氨酸轉(zhuǎn)氨酶(ALT)和天冬氨酸轉(zhuǎn)氨酶(AST)]的變化進(jìn)行比較。結(jié)果:兩組患者術(shù)中肝臟切除范圍、出血量、第一肝門血管阻斷時(shí)間及麻醉時(shí)間比較差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。與術(shù)前比較,兩組患者術(shù)后肝功能指標(biāo)均有不同程度的升高,差異有統(tǒng)計(jì)學(xué)意義(P0.05);試驗(yàn)組患者術(shù)后第1、4、6天AST、ALT水平均明顯低于對照組,白蛋白水平均明顯高于對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者術(shù)后總膽紅素水平基本接近,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。選擇Pringle法阻斷肝門,且阻斷時(shí)間≥15min的患者中,對照組患者術(shù)后AST、ALT水平高于試驗(yàn)組,白蛋白水平低于試驗(yàn)組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:門冬氨酸鳥氨酸對肝部分切除患者可快速、有效地恢復(fù)肝功能,尤其適用于選擇Pringle法阻斷肝門且阻斷時(shí)間較長的患者(有明顯的缺血再灌注損傷)。
[Abstract]:Objective: to investigate the protective effect of ornithine aspartate on ischemia reperfusion injury after partial hepatectomy. Methods: 104 patients with partial hepatectomy were divided into control group (53 cases) and experimental group (51 cases). The patients in the control group were given routine hepatoprotective drugs. The patients in the experimental group were given 10 g ornithine aspartate plus 5% glucose injection for 250 ml intravenous drip on the basis of the control group. The liver function was measured and compared between the two groups on the first day before operation and the first day after operation on the 1st day and the first day after operation on the morning of 6 days after operation, and the peripheral venous blood was drawn on an empty stomach. At the same time, the changes of main transaminase indexes (alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were compared between the two groups under different hepatic portal occlusion time. Results: there was no significant difference between the two groups in the scope of hepatectomy, the amount of blood loss, the time of the first hepatic portal vascular occlusion and the time of anesthesia (P0.05). Compared with the preoperative, the two groups of postoperative liver function indicators were increased to varying degrees, the difference was statistically significant (P0.05); The levels of AST,ALT and albumin in the test group were significantly lower than those in the control group on the 1st day and 6th day after operation (P0.05). The level of total bilirubin in the two groups was almost the same after operation, the difference was not statistically significant (P0.05). In the patients with hepatic portal occlusion with Pringle method and blocking time 鈮，

本文編號：2378868