血流阻断的缺血预处理技术在肝癌切除术中的临床应用价值  

Vascular Occlusion of the Clinical Value of Ischemic Preconditioning in Liver Cancer Resection

作　　者：陈培升[1] 罗汉传[1] 覃俊仕[1] 吴瑞正[1] 贺新新[1] 

机构地区：[1]广西医科大学第八附属医院肝胆外科,广西贵港537100

出　　处：《现代生物医学进展》2014年第21期4088-4091,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨血流阻断的缺血预处理技术在肝癌切除术中的临床应用价值。方法:选取2010年4月至2013年7月我院收治的96名原发性肝癌并采用肝脏部分切除术进行治疗的患者,将患者随机分为观察组和对照组,每组各48例,观察组在肝脏部分切除术阻断肝门血流前先分别给予1个5 min缺血和再灌注的处理。对照组不采取任何干预措施。术前、术后1天、3天、7天时分别进行生化检查,并于术前及术后1h对Fas-mRNA表达、Caspasc-3活性及AI进行测定,观察记录患者术后的并发症情况、手术时间、术中出血量以及住院时间。结果:术后1天、3天、7天时两组间的AST、ALT、TBIL等生化指标的含量情况相比,观察组均显著优于对照组(P<0.05);术后l d,两组患者ALB均有不同程度的降低,对照组低于观察组(P<0.05);术后住院时间观察组为13.28±3.85天,对照组为19.48±4.92天,观察组明显低于对照组(P<0.05);术后1h,两组患者的Fas-mRNA表达、Caspasc-3活性相比于阻断前均显著提高,但观察组提高幅度明显低于对照组,差异有统计学意义(P<0.05);两组阻断前均未见肝细胞凋亡,术后l h时,两组组均可见肝细胞凋亡,且对照组明显高于观察组组(P<0.05)。结论:血流阻断的缺血预处理技术具有操作简便、副作用小的重要特点,应用于肝癌切除术中在保护肝功能方面具有显著的优势。Objective： To investigate the blood flow blocked the clinical value of ischemic preconditioning in liver cancer resection. Methods： 96 patients with primary liver cancer and the use of partial liver resection for treatment of patients, the patients were randomly divided into observation group and control group, with 48 cases in each group, in the observation group, partial resection of hepatic hilar previously blocked blood flow were given a 5min ischemia and reperfusion treatment. Control group received no intervention. Pre operative and postoperative 1 day, 3 days, 7 days, respectively biochemical tests and lh before surgery and on postoperative Fas-mRNA expression, Caspasc-3 activity and AI were measured, observed and recorded postoperative complications in patients, operative time, blood loss and hospital stay. Results： After 1 day, 3 days, 7 days, the content of AST, ALT, TBIL in the observation group were significantly better than the control group （P 〈 0.05 ）; After 1 day,two groups of patients had significantly lower ALB, the control group was lower than in the observation group （P〈0.05）. Postoperative hospital stay in the observation group was 13.28 ＋ 3.85 days, the control grOuP was 19.48 ± 4.92 days, the observation group was significantly lower than the control group （P〈0.05）; after lh, Fas-mRNA expression, Caspasc-3 activity in two groups of patients were significantly improved compared to before the blockade, but increase rate in the observation group was significantly lower than the control group, the difference was statistically significant （P〈0.05）; Before blocking, the two groups showed no liver cell apoptosis, lh after surgery, the two groups were seen liver cell apoptosis, and significantly higher in the control group was significantly higher than in the observation group （P〈0.05）. Conclusion： Ischemic preconditioning techniques blocking blood flow is simple, side effects of important features used in liver cancer resection has significant advantages in

关 键 词：血流阻断的缺血预处理技术 原发性肝癌 肝脏部分切除术 

分 类 号：R735.7[医药卫生—肿瘤]