CAJ | 학술논문

目的：探讨奥曲肽对于肝细胞癌（HCC）合并肝炎后肝硬化和门静脉高压患者，肝切除术中肝门阻断及术后应用对术后肝功能恢复的影响。方法回顾性研究94例HCC合并肝炎后肝硬化和门静脉高压症并实施了肝切除术的患者，其中25例术中至术后5 d内持续静脉泵入奥曲肽（25μg/h），作为治疗组，另外选取69例未应用奥曲肽的患者作为对照组。观察术中肝门阻断率、术中出血量、围手术期肝功能恢复情况及前白蛋白及其水平变化。结果治疗组术中肝门阻断率（60%）较对照组（82.61%）显著降低，差异具有统计学意义（χ2=5.233，P =0.022）；两组患者出血量无统计学意义，术后第7天ALT、AST、TBil、腹水引流量治疗组均较对照组有明显恢复，差异具有统计学意义（ALT：t=-2.1443，P=0.0346；AST：t=-2.2193，P=0.0289；TBil：t=-2.2421，P=0.0274；腹水量：t =-3.0571，P =0.0029）。而两组间前白蛋白和ICG-R15水平差异无统计学意义。结论术中及围手术期应用奥曲肽，在相同术中出血量下可降低术中肝门阻断率，并显著改善术后肝功能，且不影响肝脏的合成功能，对于此类患者具有一定的临床应用价值。
목적：탐토오곡태대우간세포암（HCC）합병간염후간경화화문정맥고압환자，간절제술중간문조단급술후응용대술후간공능회복적영향。방법회고성연구94례HCC합병간염후간경화화문정맥고압증병실시료간절제술적환자，기중25례술중지술후5 d내지속정맥빙입오곡태（25μg/h），작위치료조，령외선취69례미응용오곡태적환자작위대조조。관찰술중간문조단솔、술중출혈량、위수술기간공능회복정황급전백단백급기수평변화。결과치료조술중간문조단솔（60%）교대조조（82.61%）현저강저，차이구유통계학의의（χ2=5.233，P =0.022）；량조환자출혈량무통계학의의，술후제7천ALT、AST、TBil、복수인류량치료조균교대조조유명현회복，차이구유통계학의의（ALT：t=-2.1443，P=0.0346；AST：t=-2.2193，P=0.0289；TBil：t=-2.2421，P=0.0274；복수량：t =-3.0571，P =0.0029）。이량조간전백단백화ICG-R15수평차이무통계학의의。결론술중급위수술기응용오곡태，재상동술중출혈량하가강저술중간문조단솔，병현저개선술후간공능，차불영향간장적합성공능，대우차류환자구유일정적림상응용개치。
Objective To investigate the effect of octreotide protecting liver function in hepatocellular carcinoma (HCC) patients with posthepatitic cirrhosis and portal hypertension (PHT) treated with liver resection and hepatic portal block during operation. Methods Total of 94 patients with HCC of posthepatitic cirrhosis and portal hypertension were analyzed, retrospectively. There were 25 patients in research group were continuously treated with octreotide (25μg/h) through intravenous pump in postoperative 5 days. At the same time, 69 patients in control group were not used the octreotide. The rate of hepatic portal block, intraoperative blood loss and postoperative liver function recovery were observed and analyzed, respectively. Results The rate of hepatic portal block in research group was signiifcantly lower than it in control group (60%vs 82.61%,χ2=5.233,P=0.022). There were no signiifcant difference in blood loss in the two groups. The recover of ALT, AST, TBil and ascites in 5 days after operation were significantly quickly back to normal in research group compared with which in control group (ALT:t=-2.1443, P=0.0346;AST:t=-2.2193, P=0.0289;TBil:t=-2.2421, P=0.0274;ascites:t=-3.0571, P=0.0029), while pre-albumin and ICG-R15 were with no difference in two groups. Conclusions The HCC patients with PHT are treated with octreotide in pre-and post-operative time could reduce the opportunities of hepatic portal block in liver resection, and which may be beneifcial to liver function recovery after surgery.