CAJ | 학술논문

目的探讨腹腔镜术前扩容与预防经妇科腹腔镜手术所致肝功能损害的相关性.方法将我院80例妇科腹腔镜手术患者随机分为术前扩容治疗组(Ⅰ组)和非术前扩容治疗组(Ⅱ组),每组40例；检测并对比各组患者术后肝脏缺血再灌注各个时点(T=1h、3h、6h、12h)肝功能(丙谷氨酸转氨酶ALT、天门冬氨酸转氨酶AST)及缺血再灌注损伤标记物脂质过氧化物丙二醛(MDA)在缺血再灌注期内的水平变化情况.结果 Ⅱ组肝脏缺血再灌注各个时点( T=1 h、3h、6h、12h)的肝功能血清ALT、AST水平及缺血再灌注损伤标记物MDA均明显高于Ⅰ组(P＜0.05)；各组血清ALT、AST及MDA水平在缺血再灌注期均呈增高趋势,且在再灌注6h时达高峰,但在12h时有显著回落趋势(P＜0.05)；与Ⅱ组相比,Ⅰ组在缺血再灌注期内的ALT、AST及MDA水平等实验室检查指标波动相对平稳,两组结果差异具有统计学意义(P＜0.05).结论术前扩容可有效保护腹腔镜手术患者术后肝脏缺血再灌注期的肝功能,是行之有效的预防妇科腹腔镜手术肝功能损伤的治疗措施.
목적 탐토복강경술전확용여예방경부과복강경수술소치간공능손해적상관성.방법 장아원80례부과복강경수술환자수궤분위술전확용치료조(Ⅰ조)화비술전확용치료조(Ⅱ조),매조40례；검측병대비각조환자술후간장결혈재관주각개시점(T=1h、3h、6h、12h)간공능(병곡안산전안매ALT、천문동안산전안매AST)급결혈재관주손상표기물지질과양화물병이철(MDA)재결혈재관주기내적수평변화정황.결과 Ⅱ조간장결혈재관주각개시점( T=1 h、3h、6h、12h)적간공능혈청ALT、AST수평급결혈재관주손상표기물MDA균명현고우Ⅰ조(P＜0.05)；각조혈청ALT、AST급MDA수평재결혈재관주기균정증고추세,차재재관주6h시체고봉,단재12h시유현저회락추세(P＜0.05)；여Ⅱ조상비,Ⅰ조재결혈재관주기내적ALT、AST급MDA수평등실험실검사지표파동상대평은,량조결과차이구유통계학의의(P＜0.05).결론 술전확용가유효보호복강경수술환자술후간장결혈재관주기적간공능,시행지유효적예방부과복강경수술간공능손상적치료조시.
Objective To explore the correlation of preoperative volume expansion with liver injury induced by gynecologic laparoscopic surgery.Methods 80 patients undergoing gynecologic laparoscopic surgery in our hospital were randomly divided into group of preoperative volume expansion ( group Ⅰ ) and group of non-preoperative expansion ( group Ⅱ ),40 for each group.Changes in postoperative liver function ( ALT and AST ) and ischemia-reperfusion injury marker malondialdehyde ( MDA ) during the ischemia-reperfusion period were detected at different time points( hours 1,3,6,and 12 ).Results Levels of ALT,AST,and MDA were markedly higher in group Ⅱ than in group Ⅰ at all of the different time points ( P ＜ 0.05 ).Serum levels of ALT,AST and MDA in the ischemic-reperfusion period showed a increasing trend,reached their peak values at hour 6,but declined significantly at hour 12( P＜ 0.05 ).As compared with group Ⅱ,levels of ALT,AST,and MDA were relatively stable in group Ⅰ,with a significance difference ( P＜ 0.05 ).Conclusions Preoperative volume expansion can effectively protect liver function from ischemia-reperfusion injury induced by laparoscopic surgery in patients.