肝脏缺血预处理在肝癌围手术期中的作用  

Effect of ischemic preconditioning on hepatic cancer in perioperation

作　　者：江勇[1] 吴宝强[1] 秦锡虎[1] 朱峰[1] 邹岩[1] 张东[1] 张彤[1] 陈昌泽[1] 

机构地区：[1]常州市第一人民医院肝胆外科,江苏常州213003

出　　处：《肝胆胰外科杂志》2009年第5期347-349,共3页Journal of Hepatopancreatobiliary Surgery

基　　金：江苏省卫生厅科研课题(H200870);江苏省常州市社会发展项目(CS2008912)

摘　　要：目的观察缺血预处理(ischemic preconditioning,IP)在肝癌围手术期的作用。方法IP组35例,对照组25例,IP组肝切除前采用10min/10min的缺血预处理,肝门阻断方法(Pringle手法)、肝切除方法与步骤与对照组类似,比较两组术前、术后肝酶的变化、术中出血与输血量、术后并发症、住院天数、住院费用的区别。结果两组术中肝门阻断时间、出血量、输血量无明显区别(P>0.05),术后两组肝酶均有明显升高,但IP组谷丙转氨酶在术后1d、3d、7d的升高值明显低于对照组(P<0.05),IP组术后肝功能不全的发生率、住院天数和住院费用明显较对照组低(P<0.05)。结论肝癌手术时采用缺血预处理为一简单有效的保护肝功能的方法。Objective To observe the protective effect of ischemic preconditioning （IP） in the perioperation of liver cancer. Methods IP group had 35 patients and the control group had 25. IP group patients received a 10 min ischemia followed by 10 rain perfusion before hepatectomy. The serum concentration of ALT was measured before operation and 1 day, three days and seven days after operation respectively. The intraoperatire blood loss, postoperative complications, mortality, hospitalized duration and the cost were also examined and compared between two groups. Results The ALT level in IP group was significantly lower than that in control group in one, three and seven days postoperatively （P〈0.05）. Postoperative complications, mortality, hospitalized duration and the total cost between IP group and control group also showed significant difference, and the IP group had a better prognosis than the control one. Conclusion The procedure of IP is a simple and effective method for protecting the liver function after hepatectomy in liver cancer.

关 键 词：缺血预处理 肝肿瘤 外科手术 围手术期 

分 类 号：R735.7[医药卫生—肿瘤]