术后短疗程糖皮质激素对原发性肝癌患者术后肝功能恢复的影响

发布时间：2018-08-27 20:13

【摘要】：目的:探讨原发性肝癌术后短疗程应用糖皮质激素对患者术后肝功能恢复的影响及相关不良反应。方法:回顾性分析2014年1月—2015年8月126例原发性肝癌行开腹肝切除术治疗患者的临床资料,其中63例术后常规予以护肝、补充白蛋白等治疗(对照组),另63例在以上基础上术后当日起开始连续3 d静滴甲强龙80 mg/d,后减量至40 mg/d应用2 d后停药(激素治疗组)。比较两组患者术前及术后肝功能相关指标、肝功能不全发生情况、白蛋白用量、术后并发症发生情况与住院时间。结果:两组患者术前及术中相关资料均具有可比性(均P0.05);两组术后白蛋白水平、转氨酶水平、术后白蛋白用量及住院时间差异均无统计学意义(均P0.05);激素治疗组术后第2、3天总胆红素水平、肝功能不全发生率、术后总并发症发生率均明显低于对照组(19.0%vs.34.9%,27.0%vs.44.4%)(均P0.05)。结论:原发性肝癌术后短疗程应用糖皮质激素有益于患者术后肝功能恢复,减少并发症的发生,且不会增加糖皮质相关不良反应。
[Abstract]:Objective: to investigate the effect of glucocorticoid on postoperative liver function recovery and related adverse reactions in patients with primary liver cancer. Methods: the clinical data of 126 patients with primary liver cancer undergoing open hepatectomy from January 2014 to August 2015 were analyzed retrospectively. On the basis of above mentioned above, 63 cases were treated with Albumin supplementation (control group), and the other 63 cases were treated by intravenous methadone 80 mg/d, for 3 days and then reduced to 40 mg/d after 2 days (steroid treatment group). The relative indexes of liver function before and after operation, the incidence of hepatic insufficiency, the dosage of albumin, the incidence of postoperative complications and the hospitalization time were compared between the two groups. Results: the data of preoperative and intraoperative correlation were comparable between the two groups (P0.05), the levels of albumin, aminotransferase, and aminotransferase in the two groups were significantly higher than those in the control group (P 0.05). The level of total bilirubin, the incidence of hepatic insufficiency and the incidence of postoperative complications in the hormone treatment group were significantly lower than those in the control group (19.0vs.34.9cm 27.0vs.44.4%) (P0.05). Conclusion: the application of glucocorticoid in the short course of postoperative treatment of primary liver cancer is beneficial to the recovery of liver function and the reduction of complications, and does not increase the adverse effects of glucocorticoid.
【作者单位】：中南大学湘雅医院普外肝脏外科;
【分类号】：R735.7

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