CAJ | 학술논문

目的探讨门冬氨酸鸟氨酸对肝切除患者术后肝功能的保护作用.方法肝切除患者82例,随机数字法分为对照组40例和研究组42例.对照组给予常规护肝治疗.研究组在对照组治疗措施的基础上,术前1 d应用门冬氨酸鸟氨酸15 g加入5%葡萄糖注射液500 ml静脉滴注,连续用药7 d.分别于术前和术后1、3、7 d晨起空腹测定外周静脉血血清ALT、AST、GGT、胆红素、血氨含量.结果 2组术中肝门阻断的例数及阻断时间差异无统计学意义,同时2组患者肝脏切除方式、切除范围、术中出血量及手术时间差异亦无统计学意义.2组术后肝功能指标与术前相比,有一定程度的升高,差异有统计学意义(均P＜0.05).对照组术后1、3、7 d ALT、AST[ALT分别为(175.27±68.35)、(97.37±34.24)、(78.28±19.73)U/L,AST分别为(152.29 ±31.65)、(115.28±35.24)、(82.49±28.18)U/L]均明显高于研究组[ALT分别为(115.58±69.20)、(81.36±14.55)、(61.24±11.32)U/L,AST分别为(127.29±33.61)、(95.26±16.83)、(55.16±14.83)U/L],差异有统计学意义(均P＜0.05).对照组术后1、3 d的GGT水平明显高于研究组[对照组术后1、3d分别为(325.58±38.19)、(265.68±15.27)U/L,研究组分别为(284.58±19.35)、(204.35±12.35)U/L],差异有统计学意义(P＜0.05).2组术后胆红素水平差异无统计学意义(P＞0.05).肝门阻断＞15 min患者中,研究组患者术后AST、ALT水平明显低于对照组(P＜0.05).结论门冬氨酸鸟氨酸对肝切除术尤其是肝门阻断时间长的肝损害具有明显保护作用,适合在肝脏围手术期使用.
목적 탐토문동안산조안산대간절제환자술후간공능적보호작용.방법 간절제환자82례,수궤수자법분위대조조40례화연구조42례.대조조급여상규호간치료.연구조재대조조치료조시적기출상,술전1 d응용문동안산조안산15 g가입5%포도당주사액500 ml정맥적주,련속용약7 d.분별우술전화술후1、3、7 d신기공복측정외주정맥혈혈청ALT、AST、GGT、담홍소、혈안함량.결과 2조술중간문조단적례수급조단시간차이무통계학의의,동시2조환자간장절제방식、절제범위、술중출혈량급수술시간차이역무통계학의의.2조술후간공능지표여술전상비,유일정정도적승고,차이유통계학의의(균P＜0.05).대조조술후1、3、7 d ALT、AST[ALT분별위(175.27±68.35)、(97.37±34.24)、(78.28±19.73)U/L,AST분별위(152.29 ±31.65)、(115.28±35.24)、(82.49±28.18)U/L]균명현고우연구조[ALT분별위(115.58±69.20)、(81.36±14.55)、(61.24±11.32)U/L,AST분별위(127.29±33.61)、(95.26±16.83)、(55.16±14.83)U/L],차이유통계학의의(균P＜0.05).대조조술후1、3 d적GGT수평명현고우연구조[대조조술후1、3d분별위(325.58±38.19)、(265.68±15.27)U/L,연구조분별위(284.58±19.35)、(204.35±12.35)U/L],차이유통계학의의(P＜0.05).2조술후담홍소수평차이무통계학의의(P＞0.05).간문조단＞15 min환자중,연구조환자술후AST、ALT수평명현저우대조조(P＜0.05).결론 문동안산조안산대간절제술우기시간문조단시간장적간손해구유명현보호작용,괄합재간장위수술기사용.
Objective To investigate the protective effects of L-Ornithine-L-Aspartate on liver function in patients after liver resection. Methods Eighty-two patients undergoing liver resection were randomly divided into study group and control group. Control group was treated with conventional therapy and study group had conventional therapy plus L-Ornithine-L-Aspartate for injection intravenously from the first day before operation to the seven day after operation. The fasting alanine aminotransferase (ALT), aspartate aminotransferase ( AST ), γ-glutamyl transpeptadase(GGT), total bilirubin(TB), direct bilirubin(DB) and blood ammonia(BA) levels were determined before operation and on days 1, 3 and 7 after operation. Results On days 1, 3 and 7 after operation, ALT and AST levels in the study group [ALT: ( 115.58 ± 69. 20), (81. 36 ± 14. 55 ), ( 61.24 ± 11. 32) U/L; AST: ( 127.29 ±33.61 ), (95.26 ± 16.83 ), (55.16 ± 14.83 )U/L] were significantly lower than those in the control group[ALT:(175.27 ±68.35), (97.37 ±34.24), (78.28 ± 19. 73) U/L;AST: (152. 29 ±31.65), (115.28 ±35.24),(82.49 ± 28.18) U/L] (P ＜ 0.05 ). In the study group of the porta blocked over 15 min, levels of AST, ALT were obviously lower than that of the control group( P ＜ 0. 05 ). Conclusions L-Ornithine-L-Aspartate for injection can alleviate the hepatic dysfunction after hepatectomy, especially in the long time of porta blocked and has protective advantage for liver function.