门冬氨酸鸟氨酸对肝部分切除术后缺血再灌注损伤的保护作用
发布时间：2018-12-14 15:28
【摘要】：目的:探讨门冬氨酸鸟氨酸对肝部分切除术后缺血再灌注损伤的保护作用。方法:选取肝部分切除术患者104例(均行肝门区域血管阻断),按随机数字表法分为对照组53例和试验组51例。对照组患者给予常规保肝药物,试验组患者在对照组基础上再予门冬氨酸鸟氨酸10 g加入5%葡萄糖注射液250 ml中静脉滴注,于术前开始应用,连续用药7 d。两组患者分别于术前第1天和术后第1、4、6天清晨空腹抽外周静脉血检测肝功能并进行比较,同时对不同肝门阻断时间下两组患者术后主要转氨酶指标[丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST)]的变化进行比较。结果:两组患者术中肝脏切除范围、出血量、第一肝门血管阻断时间及麻醉时间比较差异均无统计学意义(P0.05)。与术前比较,两组患者术后肝功能指标均有不同程度的升高,差异有统计学意义(P0.05);试验组患者术后第1、4、6天AST、ALT水平均明显低于对照组,白蛋白水平均明显高于对照组,差异有统计学意义(P0.05);两组患者术后总胆红素水平基本接近,差异无统计学意义(P0.05)。选择Pringle法阻断肝门,且阻断时间≥15min的患者中,对照组患者术后AST、ALT水平高于试验组,白蛋白水平低于试验组,差异有统计学意义(P0.05)。结论:门冬氨酸鸟氨酸对肝部分切除患者可快速、有效地恢复肝功能,尤其适用于选择Pringle法阻断肝门且阻断时间较长的患者(有明显的缺血再灌注损伤)。
[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，
本文编号：2378868
[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，
本文编号：2378868
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