帕瑞昔布在右肝部分切除术中的应用及对肝脏缺血再灌注损伤的影响  

Application of parecoxib in partial right hepatectomy and its influence on hepatic ischemia-reperfusion injury

作　　者：张青 王亦瑶 周勇[1] 周威[1] Zhang Qing;Wang Yiyao;Zhou Yong;Zhou Wei(Department of Anesthesiology,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院麻醉科,南阳473000

出　　处：《中国实用医刊》2024年第17期92-95,共4页Chinese Journal of Practical Medicine

基　　金：2023年度南阳市科技发展计划项目(23KJGG098)。

摘　　要：目的分析帕瑞昔布在右肝部分切除术中的应用及对肝脏缺血再灌注损伤的影响。方法队列研究。抽取2021年4月至2023年4月南阳市中心医院收治的右肝部分切除术患者84例,按随机数字表法分为帕瑞昔布组与生理盐水组,每组42例。生理盐水组术前给予40 mg生理盐水,帕瑞昔布组术前给予40 mg帕瑞昔布。比较两组围术期情况、肝功能[丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)]、炎症因子[C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)]水平及一氧化氮(NO)、内皮素1(ET-1)水平。结果两组手术时间、术中出血量、肝门阻断时间比较差异未见统计学意义(P>0.05)。术后24、72 h,帕瑞昔布组ALT、AST、CRP、TNF-α、ET-1水平低于生理盐水组,NO水平高于生理盐水组(P<0.05)。结论帕瑞昔布应用于右肝部分切除术,可减轻炎性反应和肝脏缺血再灌注损伤,并减轻对肝功能的影响。Objective To analyze the application of parecoxib in partial right hepatectomy and its influence on hepatic ischemia-reperfusion injury.Methods A total of 84 patients who underwent partial resection of the right liver in Nanyang Central Hospital from April 2021 to April 2023 were selected for the cohort study.And they were divided into the parecoxib group and the normal saline group by random number table method,with 42 cases in each group.The normal saline group was given 40 mg physiological saline before surgery,while the parecoxib group was given 40 mg parecoxib before surgery.The perioperative conditions,liver function assessed by alanine transaminase(ALT),aspartate transaminase(AST),and levels of inflammatory factors including C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α),and levels of nitric oxide(NO)and endothelin-1(ET-1)of the two groups were compared.Results There was no significant difference in operation duration,intraoperative blood loss and hepatic portal occlusion time between the two groups(P>0.05).At 24 and 72 hours after operation,levels of ALT,AST,CRP,TNF-αand ET-1 in the parecoxib group were lower than those in the normal saline group,while NO was higher than that in the normal saline group(P<0.05).Conclusions Application of parecoxib in partial right hepatectomy can reduce inflammatory response and hepatic ischemia-reperfusion injury,and reduce the impact on liver function.

关 键 词：帕瑞昔布 右肝部分切除术 肝脏缺血再灌注损伤 

分 类 号：R657.3[医药卫生—外科学]