腹腔镜左肝蒂阻断术对肝内胆管结石患者肝功能与应激指标及血清蛋白水平的影响  

Effect of laparoscopic left hepatic pedicle occlusion on liver function,stress index and serum protein level in patients with hepatolithiasis

作　　者：袁国辉 蒋燦 许剑峰[1] 梅保华[1] YUAN Guohui;JIANG Can;XU Jianfeng;MEI Baohua(Department of Hepatobiliary and Pancreatic Surgery,Jiujiang City First People's Hospital,Jiujiang,Jiangxi,332000,China)

机构地区：[1]九江市第一人民医院肝胆胰外科,江西九江332000

出　　处：《当代医学》2023年第4期90-93,共4页Contemporary Medicine

摘　　要：目的探讨腹腔镜左肝蒂阻断术对肝内胆管结石患者肝功能、应激指标及血清蛋白水平的影响。方法选取2020年3月至2021年5月本院收治的86例左肝内胆管结石患者作为研究对象,按照随机摸球法分为观察组与对照组,每组43例。对照组行常规开腹手术治疗,观察组行腹腔镜左肝蒂阻断术治疗,比较两组肝功能指标、应激指标及血清蛋白水平。结果术后,两组天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)水平均明显高于术前,但观察组明显低于对照组,差异有统计学意义(P<0.05)。术后,两组肾上腺素、皮质醇水平均明显高于术前,但观察组低于对照组,差异有统计学意义(P<0.05)。术后,两组血清白蛋白、前白蛋白水平均明显低于术前,但观察组高于对照组,差异有统计学意义(P<0.05)。结论腹腔镜左肝蒂阻断术治疗肝内胆管结石效果显著,可促进患者肝功能恢复,减轻机体对手术的应激反应,有助于血清蛋白水平的恢复,值得临床推广应用。Objective To investigate the effect of laparoscopic left hepatic pedicle occlusion on liver function,stress index and serum protein level in patients with hepatolithiasis.Methods 86 patients with left hepatolithiasis admitted to our hospital from March 2020 to May 2021 were selected as the study subjects,and they were divided into the observation groups and the control group according to the random ball touch method,with 43 cases in each group.The control group was treated with conventional open surgery,and the observation group was treated with laparoscopic left hepatic pedicle occlusion,the liver function indexes,stress indexes and serum protein levels were compared between the two groups.Results After operation,the levels of aspartate aminotransferase(AST)and alanine aminotransferase(ALT)of the two groups were significantly higher than those before operation,but the observation group was significantly lower than the control group,and the differences were statistically significant(P<0.05).After operation,the epinephrine and cortisol levels of the two groups were significantly higher than those before operation,but the observation group was lower than the control group,and the differences were statistically significant(P<0.05).After operation,the serum albumin and prealbumin levels of the two groups were significantly lower than those before operation,but the observation group was higher than the control group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic left hepatic pedicle occlusion has significant effect in the treatment of hepatolithiasis,which can promote the recovery of liver function,reduce the body's stress response to operation and help the recovery of serum protein levels,which is worthy of clinical promotion and application.

关 键 词：腹腔镜左肝蒂阻断 肝内胆管结石 肝功能 应激指标 血清蛋白 

分 类 号：R657.3[医药卫生—外科学]