肝内胆管结石患者行腹腔镜下肝叶切除术的临床效果研究  

Clinical effects of laparoscopic hepatolobectomy in patients with intrahepatic bile duct stones

作　　者：余培[1] 钟艳霞[1] 

机构地区：[1]湖北省十堰市房县人民医院普外科,湖北房县442100

出　　处：《海南医学院学报》2016年第6期568-570,573,共4页Journal of Hainan Medical University

基　　金：湖北省自然科学基金(2012FKC143)~~

摘　　要：目的:研究肝内胆管结石患者行腹腔镜下肝叶切除术的临床效果。方法:选择接受肝叶切除术的肝内胆管结石患者进行研究,筛选进行腹腔镜手术的患者和进行开腹手术的患者分别纳入腹腔镜组和开腹组,比较两组应激反应程度、肝损伤程度以及Nrf2-ARE信号通路功能。结果:T1、T2时间点时,两组应激指标、Nrf2-ARE信号通路功能无差异;T3、T4时间点时,腹腔镜组血糖、皮质醇以及血管紧张素水平较低,而胰岛素水平以及Nrf2、ARE含量较高;T4时间点时,腹腔镜组8-OhdG、PCO、CYP1A、CYP3A含量较低。结论:腹腔镜下肝叶切除术有助于缓解应激反应、保护肝细胞免受损失、增强Nrf2-ARE信号通路功能,是治疗肝内胆管结石理想的手术方式。Objective： To investigate the clinical effects of laparoscopic hepatolobectomy in patients with intrahepatic bile duct stones. Methods： Patients with intrahepatic bile duct stones receiving hepatolohectomy were chosen for study, pa tients receiving laparoscopic surgery and patients receiving open surgery were screened and enrolled in laparoscopic group and open group respectively, and then degree of stress response, degree of liver damage and Nrf2-ARE signaling pathway function of two groups were compared. Results： At time points of T1 and T2, stress indicators and Nrf2-ARE signaling pathway func tion of two groups were not significantly different; at T3 and T4, blood sugar, cortisol and angiotensin levels of laparoseopic group were lower, but insulin level as well as Nrf2 and ARE contents were higher; at T4 point in time, 8-OhdG, PCO, CYPIA and CYP3A contents of laparoscopic group were lower. Conclusion： Laparoscopic hepatolobectomy helps to relieve stress response, protect liver cells from damage and enhance Nrf2-ARE signaling pathway function; it＇s an ideal method of sur gical treatment of intrahepatic bile duct stones.

关 键 词：肝内胆管结石 肝叶切除术 腹腔镜 应激反应 信号通路 

分 类 号：R657.4[医药卫生—外科学]