妇科疾病合并脂肪肝围术期处理78例分析  

Perioperative Management of Patients with Gynecological Diseases Complicated by Fatty Liver: Analysis of 78 Cases

作　　者：戴燕[1] 刘超斌[1] 林丹玫[1] 郑惠英[1] 洪新如[2] 

机构地区：[1]福建省妇幼保健院妇产科,福州350001 [2]南京军区福州总医院妇产科,福州350025

出　　处：《福建医科大学学报》2009年第6期503-506,共4页Journal of Fujian Medical University

摘　　要：目的探讨妇科疾病合并脂肪肝的围术期处理,以减轻术后肝功能损害。方法回顾分析78例妇科手术合并脂肪肝患者的围术期处理和手术对术后肝功能等的影响。结果轻度60例、中度17例、重度1例,术后肝功能损害发生率,随脂肪肝程度加重、手术范围扩大、手术时间延长而显著升高;气管-静脉全麻术后肝功能损害发生率显著高于单纯腰硬麻醉。结论妇科疾病合并脂肪肝患者多伴肝功能不全或肝功能储备降低,手术可加重肝功能损害。术前客观评估肝功能,采取必要的保肝治疗,选择合适的手术和麻醉方式,可降低肝功能损害,提高手术安全性。Objective To explore appropriate perioperative management of patients with gynecological diseases complicated by fatty liver in order to alleviate possible postoperative hepatic impairment.Methods The effects of gynecological surgery and perioperative management were retrospectively analyzed on postoperative liver function in 78 cases that had been operated gynecologically. Results There were 60 cases with mild, 17 with moderate, and 1 with severe fatty liver. The postoperative incidence of hepatic dysfunction was significantly increased as the fatty liver aggravated and scope and duration of the operations increased. The incidence of liver function impairment was significantly higher in the patients receiving trachea-vein general anesthesia than in those receiving lumbar-continuous epidural anesthesia. Conclusions Patients with gynecological diseases complicated by fatty liver frequently suffer from hepatic insufficiency or decreased hepatic functional reserve, which can be further deteriorated by gynecological surgery. Measures, including the evaluation of liver function and requisite treatments on maintenance and restoration of liver function, should be taken preoperatively to decrease the postoperative liver function damage and to improve surgical safety.

关 键 词：脂肪肝 生殖器疾病 女(雌)性 手术期间 

分 类 号：R713[医药卫生—妇产科学] R575.505.31[医药卫生—临床医学]