血必净联合腹腔镜胆总管探查术对复杂肝外胆管结石患者血清炎性指标及肝损伤标志物的影响  

Effects of Xuebijing combined with laparoscopic common bile duct exploration on serum inflammatory indexes and markers of liver injury in patients with complex extrahepatic biliary calculi

作　　者：柳扬[1] 范伟[1] LIU Yang;FAN Wei(Department of Hepatobiliary SurgeryⅡ,Guizhou Provincial People′s Hospital,Guiyang 550002,China)

机构地区：[1]贵州省人民医院肝胆外科二部,贵阳市550002

出　　处：《临床合理用药》2025年第2期8-11,共4页Chinese Journal of Clinical Rational Drug Use

基　　金：贵州省卫健委基金课题(gzwkj2021-175)。

摘　　要：目的观察血必净联合腹腔镜胆总管探查术对复杂肝外胆管结石患者血清炎性指标及肝损伤标志物的影响。方法选择2022年3月—2023年9月贵州省人民医院收治的复杂肝外胆管结石患者92例为研究对象,采用信封法随机分为观察组和对照组,每组46例。对照组采用腹腔镜胆总管探查术治疗,观察组采用血必净联合腹腔镜胆总管探查术治疗。治疗7 d后,比较2组治疗前后血清炎性指标[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-1(IL-1)、白介素-1β(IL-1β)、白介素-6(IL-6)]、肝损伤标志物[总胆汁酸(TBA)、α-谷胱甘肽S转移酶(α-GST)、嘌呤核苷磷酸化酶(PNP)、精氨酸酶Ⅰ(ArgⅠ)、谷氨酸脱氢酶(GLDH)、鸟氨酸氨甲酰基转移酶(OCT)]及术后并发症发生率。结果治疗7 d后,2组CRP、TNF-α、IL-1、IL-1β及IL-6水平均低于治疗前,且观察组低于对照组(P<0.01);2组TBA、α-GST、PNP、ArgⅠ、GLDH及OCT水平均高于治疗前,但观察组低于对照组(P<0.01)。观察组并发症总发生率低于对照组(4.35%vs.17.39%,χ^(2)=4.039,P=0.044)。结论血必净联合腹腔镜胆总管探查术用于复杂肝外胆管结石患者中效果较好,可降低血清炎性指标和肝损伤标志物水平,有助于降低术后并发症发生率。Objective To observe the effects of Xuebijing combined with laparoscopic common bile duct exploration on serum inflammatory indexes and markers of liver injury in patients with complex extrahepatic biliary calculi.Methods Ninety-two patients with complex extrahepatic biliary calculi admitted to Guizhou Provincial People′s Hospital from March 2022 to September 2023 were selected as the study objects,and were randomly divided into observation group and control group by envelope method,with 46 cases in each group.The control group was treated with laparoscopic common bile duct exploration,and the observation group was treated with Xuebijing combined with laparoscopic common bile duct exploration.After 7 days of treatment,serum inflammatory indexes(CRP,TNF-α,IL-1,IL-1β,IL-6),liver injury markers(TBA,α-GST,PNP,ArgⅠ,GLDH,OCT)before and after treatment,and postoperative complications between the two groups were compared.Results After 7 days of treatment,the levels of CRP,TNF-α,IL-1,IL-1βand IL-6 in two groups were lower than before treatment,and the levels in observation group were lower than those in control group(P<0.01).The levels of TBA,α-GST,PNP,ArgⅠ,GLDH and OCT in two groups were higher than before treatment,but those in observation group were lower than those in control group(P<0.01).The overall complication rate of the observation group was lower than that of the control group(4.35%vs.17.39%,χ^(2)=4.039,P=0.044).Conclusion Xuebijing combined with laparoscopic common bile duct exploration is effective in patients with complex extrahepatic biliary calculi,which can reduce the level of serum inflammatory markers and liver injury markers,and help reduce the incidence of postoperative complications.

关 键 词：复杂肝外胆管结石 血必净 腹腔镜胆总管探查术 炎性指标 肝损伤标志物 术后并发症 

分 类 号：R657.4[医药卫生—外科学]