恶性梗阻性黄疸围手术期液体疗法促进减黄的疗效  

The Effects of Supplement of Sufficient Liquid on Patients with Severe Obstructive Jaundice

作　　者：张利辉[1] 崔忠[1] 孙建斌[1] 王振全[1] 赵清涛[1] 

机构地区：[1]白求恩国际和平医院肝胆外科,石家庄050082

出　　处：《白求恩军医学院学报》2005年第4期199-201,共3页Journal of Bethune Military Medical College

摘　　要：目的探讨恶性梗阻性黄疸病人围手术期液体疗法促进减黄的疗效。方法收集我院 1997-2003年手术治疗血清总胆红素>171 μmol／L恶性梗阻性黄疸病人的临床资料进行回顾性分析,在解除胆道梗阻术中、术后增加补液量,观察液体治疗在短期内促进减黄的作用。结果液体组术后一周内91．4％的病例总胆红素降至171μmol／L以下,液体组比对照组术后血清胆红素下降50％的时间显著缩短(P<0．01)。只要达到充分胆道引流,短期内液体组减黄速度与原发病、手术种类无关。TB与ALP 显著相关,而TB和ALP与其他各值之间无显著相关关系。液体组术后一周内日尿量2 500-3 000 ml与日尿量>3 000 ml的降黄速度无明显差异。结论恶性梗阻性黄疸病人在手术解除胆道梗阻同时增加术中、术后补液量,通过利尿可达到促进减黄,减少术后各种并发症发生。Objective To explore the effects of supplement of sufficient liquid on patients with severe obstructive jaundice in perioperative period. Methods The patients with the server obstructive jaundice （serum bilirubin 〉 171 μmol/L） were collected from 1997 to 2003 in Bathune International Peace Hospital. Different quantity of liquid was supplied and the reducing effect of jaundice was compared. Results The total serum bilirubin in 91.4 % eases of liquid group was decreased less than 171 μmol/L during a week.The time that serum bilitubin was reduced by 50% was significantly shorter in liquid group compared with the control group. If the bile tract drainage was enough, the speed of jaundice-vanishing of the liquid group was associated with the primary disease or the kinds of operation in the short period. The post-operation liver functions comparing with the pre-operation in liquid group showed that TB was evidently correlation with ALP,but TB and ALP were not correlated to other liver fimction.The speed of jaundice-vanishing was similar between urine quantum in 24 hours less and more than 3 000 ml in the first week after operation in liquid group. Conclusion The supplement of sufficient liquid is rapid, effective way on patients with severe obstructive jaundice and can prevent serious complication.

关 键 词：恶性梗阻性黄疸 围手术期 减黄 液体疗法 

分 类 号：R657.43[医药卫生—外科学]