腹腔镜胆囊切除术中不同气腹压力对人体肝脏功能的影响  

Influence of different pneumoperitoneal pressure on human hepatic function in laparoscopic cholecystectomy

作　　者：李铁[1] 王曙光[2] 

机构地区：[1]沈阳军区解放军第230医院普通外科,118000 [2]第三军医大学西南医院全军肝胆外科研究所,400038

出　　处：《消化外科》2002年第4期263-266,共4页Journal of Digestive Surgery

摘　　要：目的 观察腹腔镜肿囊切除术中不同气腹压力对人体肝脏功能的影响。方法 将97例病人分为低气腹压组和高气腹压组,比较两组间术后肝功能的变化。结果 与低气腹压组比较,高气腹压组天门冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、总胆红素（TBil）、间接胆红素（IBil）升高明显,且恢复较晚,而两组血清吲哚氰绿滞留试验（ICGR15）和动脉血酮体比值（AKBR）变化则差异不大。结论 对于术前肝功能正常的病人,不同气腹压力对人体肝脏功能产生不同的影响,其中尤以对血清转氨酶和血清胆红素的影响较为突出,而对肝脏的储备功能和能量代谢状态无明显影响。Objective To investigate the influence of different pneumoperitoneal pressure on human hepatic function in laparoscopic cholecystectomy. Methods Ninety seven patients were randomly divided into low pneumoperitoneal pressure group and high pneumoperitoneal pressure group, the change of hepatic function of both groups after operation was observed. Results The levels of glutamic - oxaloacetic transuminase, glutamic - pyruvic transaminase, total bilirubin, indirect biliiubin of the high pneumoperitoneal pressure group increased more significantly than those of the low pneumoperitoneal pressure group, and restored later, but the changes of indocyanine - green test and arterial ketone body ratio of both groups were not very obvious. Conclusions Different pneumoperitoneal pressure produced different influence on hepatic function in patients with normal hepatic function before operation. The influence on serum transaminase and bilirubin was prominent, but the influence on hepatic reserve function and state of energy metabolism was not so evident.

关 键 词：腹腔镜 胆囊切除术 气腹压 肝功能 肝脏缺血再灌注损伤 

分 类 号：R657.4[医药卫生—外科学]