中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2008年
15期
1136-1138
,共3页
王野%杨甲梅%胡明华%李殿启%牛文洋%刘鹏%侯元凯%吴孟超
王野%楊甲梅%鬍明華%李殿啟%牛文洋%劉鵬%侯元凱%吳孟超
왕야%양갑매%호명화%리전계%우문양%류붕%후원개%오맹초
肝移植%门静脉淤血%内毒素类%肝功能
肝移植%門靜脈淤血%內毒素類%肝功能
간이식%문정맥어혈%내독소류%간공능
Liver transplantation%Portal blood stasis%Endotoxins%Liver function
目的 探讨肝移植术中不同门静脉淤血去除量对术后内毒素血症及肝功能恢复的影响.方法 将2006年2月至2007年11月收治的47例肝移植患者按术中门静脉淤血去除量的不同分为两组:A组(n=26,门静脉淤血去除50 ml)和B组(n=21,门静脉淤血去除200 ml),检测受者手术前后血清内毒素、D-乳酸、肿瘤坏死因子-α、白细胞介素-6、肝功能及凝血功能的变化情况并进行分析比较.结果 两组在性别、年龄、原发疾病类型、Child-pugh分级、供肝冷缺血时间、手术时间、无肝期时间、手术方式、出血量、输血量及术前各项检测指标无显著差异的条件下,B组术后血清内毒素、D-乳酸、肿瘤坏死因子-α、白细胞介素-6、谷氨酸转氨酶、天冬氨酸转氨酶、凝血酶原时间、部分凝血活酶时间均明显低于A组(P<0.05);前白蛋白明显高于A组(P<0.05).结论 肝移植术中门静脉淤血去除200 ml效果优于50 ml,可以更好地减轻术后内毒血症,并有助于肝功能的恢复.
目的 探討肝移植術中不同門靜脈淤血去除量對術後內毒素血癥及肝功能恢複的影響.方法 將2006年2月至2007年11月收治的47例肝移植患者按術中門靜脈淤血去除量的不同分為兩組:A組(n=26,門靜脈淤血去除50 ml)和B組(n=21,門靜脈淤血去除200 ml),檢測受者手術前後血清內毒素、D-乳痠、腫瘤壞死因子-α、白細胞介素-6、肝功能及凝血功能的變化情況併進行分析比較.結果 兩組在性彆、年齡、原髮疾病類型、Child-pugh分級、供肝冷缺血時間、手術時間、無肝期時間、手術方式、齣血量、輸血量及術前各項檢測指標無顯著差異的條件下,B組術後血清內毒素、D-乳痠、腫瘤壞死因子-α、白細胞介素-6、穀氨痠轉氨酶、天鼕氨痠轉氨酶、凝血酶原時間、部分凝血活酶時間均明顯低于A組(P<0.05);前白蛋白明顯高于A組(P<0.05).結論 肝移植術中門靜脈淤血去除200 ml效果優于50 ml,可以更好地減輕術後內毒血癥,併有助于肝功能的恢複.
목적 탐토간이식술중불동문정맥어혈거제량대술후내독소혈증급간공능회복적영향.방법 장2006년2월지2007년11월수치적47례간이식환자안술중문정맥어혈거제량적불동분위량조:A조(n=26,문정맥어혈거제50 ml)화B조(n=21,문정맥어혈거제200 ml),검측수자수술전후혈청내독소、D-유산、종류배사인자-α、백세포개소-6、간공능급응혈공능적변화정황병진행분석비교.결과 량조재성별、년령、원발질병류형、Child-pugh분급、공간랭결혈시간、수술시간、무간기시간、수술방식、출혈량、수혈량급술전각항검측지표무현저차이적조건하,B조술후혈청내독소、D-유산、종류배사인자-α、백세포개소-6、곡안산전안매、천동안산전안매、응혈매원시간、부분응혈활매시간균명현저우A조(P<0.05);전백단백명현고우A조(P<0.05).결론 간이식술중문정맥어혈거제200 ml효과우우50 ml,가이경호지감경술후내독혈증,병유조우간공능적회복.
Objective To investigate the inflence of the amount of portal blood stasis removal on endotoxemia and liver function after liver transplantation. Methods Forty-seven patients who received liver transplantation from February 2006 to November 2007 were divided into 2 groups according to the amount of portal blood stasis removal during operation:group A (n=26) 50 ml and group B (n =21 ) 200 ml of portal blood stasis removal respectively. The levels of plasma endotoxin, D-lactate, tumor necrosis factor-α, intedeukin-6, liver function and blood coagulation were examined and analyzed. Results Under the condition of no significant difference in sex, age, primary liver diseases and Child-pngh's classification, cold ischemic time,total operation and anhepatic time, operation methods, volume of blood loss and transfusion, and all preoperative observations. Most of observations showed the restoration of the patients in group B was better than that in group A. The plasma levels of endotoxin, D-lactate, tumor necrosis factor-α, intedeukin-6, alanine aminotransferase, aspartate aminotransferase, prothrombin time and activated partial thromboplastin time in group B were significantly lower than those in group A ( P < 0. 05 ). The level of plasma prealbumin in group B was significantly higher than that in group A (P<0.05). Conclusions The removal of 200 ml portal blood stasis leads to a better results than that of 50 ml, and it can help alleviate endotoxemia and facilitate the restoration of the liver function after liver transplantation.
