护肝药物对心脏体外循环术后肝功能异常患者的疗效分析  

Effects of hepatoprotective drugs in patients with liver dysfunction after cardiopulmonary bypass

作　　者：张春娟 毛琦琦 赵蕊[3] Zhang Chunjuan;Mao Qiqi;Zhao Rui(Department of Pharmacy,Haiyan People′s Hospital,Jiaxing,Zhejiang 314300,China;Department of pharmacy,Jiangshan People′s Hospital,Quzhou,Zhejiang 324000,China;Department of Pharmacy,Shao Yifu Hospital Affili-ated to Zhejiang University School of Medicine,Hangzhou,Zhejiang 310000,China)

机构地区：[1]海盐县人民医院药剂科,浙江嘉兴314300 [2]江山市人民医院药剂科,浙江衢州324000 [3]浙江大学医学院附属邵逸夫医院药学部,浙江杭州310000

出　　处：《中国药物与临床》2025年第4期261-266,共6页Chinese Remedies & Clinics

摘　　要：目的分析护肝药物干预对体外循环(CPB)术后指标异常患者的疗效。方法回顾性收集2022—2023年浙江大学医学院附属邵逸夫医院CPB术后入重症监护病房(ICU)出现肝功能指标异常(aLFT)的危重症患者数据,按照有无使用护肝药物将其分为对照组和观察组,观察组接受护肝药物的对症治疗,对照组不接受护肝治疗。观察主要结局是肝功能好转时间,次要结局是总住院时间、CPB术后住院时间。结果共纳入88例患者,主要表现有转氨酶升高和胆红素升高,出现aLFT峰值的中位时间是1 d。38例患者接受护肝治疗,2组aLFT好转时间对比,差异无统计学意义,总住院时间和术后住院时间对比,差异无统计学意义;Lasso回归和Cox回归分析发现术后是否伴肾损害是aLFT好转时间的独立危险因素(P<0.05)。结论CPB术前肝功能正常,术后早期(3 d内)出现的aLFT可能是短暂/一过性的,护肝治疗药物的干预差异无统计学意义,对其有效性不高。Objective To explore the efficacy of hepatoprotective drugs in patients after cardiopulmonary bypass(CPB)with liver dysfunction.Methods The retrospective observational study was conducted on 88 patients with abnormal liver function test(aLFT)who admitted to the Intensive Care Unit following cardiac CPB surgery from 2022 to 2023.All the patients were divided into a control group and an observation group.The observation group received appropriate HP treatment(HP+),while the control group were HP-.The primary outcome was the aLFT recovery time,and the secondary outcomes were hospital time and postoperative length of stay.Results A total of 88 patients were enrolled,mainly presenting with elevated transaminase and bilirubin.The median time for the appearance of aLFT peak was 1 day.A total of 38 patients received hepatoprotective treatment(HP),and there was no statistical significance in the comparison of the recovery time of aLFT between the two groups.The comparison of total hospital stay and postoperative hospital stay also showed no statistical significance.The lasso regression and cox regression analyses revealed that the presence of renal impairment postoperatively was an independent risk factor for the time to improvement of aLFT(P<0.05).Conclusion Most of the aLFT that occurs early after CPB surgery(within 3 days)may be transient,there is no statistically significant difference in the intervention of HP drugs.

关 键 词：体外循环手术 肝疾病 护肝治疗 治疗结果 预后 

分 类 号：R654.2[医药卫生—外科学]