摘要
目的 探讨腺苷蛋氨酸对肝切除时急性肝功能损害的保护作用。方法 自 2 0 0 2年 7月～ 2 0 0 2年 1 1月东方肝胆外科医院特需科收治的、肝门阻断后肝切除术的 4 0例肝肿瘤患才 ,进行术后护肝治疗。随机分成三组 :A组 (n=1 0 ) ,腺苷蛋氨酸 +甘利欣 ;B组 (n=1 0 ) ,腺苷蛋氨酸 +甘利欣 +苦参碱 ;C组 (n=2 0 ) ,腺苷蛋氨酸。治疗从手术当天开始 ,连续 7天 ,除使用 1 ,6 -二磷酸果糖 (FDO)外 ,均不用其他保肝药物。术后第 3、7天测定血清总胆红素 (TBil)、直接胆红素 (DBil)、谷丙转氨酶(AL T)、谷草转氨酶 (AST)、γ-谷氨酰转肽酶 (γ- GT)、碱性磷酸酶 (AL P)和前白蛋白 (PAB) ;术后第 4、8天评估患者的食欲和疲劳状况。 1 1例 Caroli病人 ,对其临床资料进行回顾性总结。结果 肝功能各指标在手术前后均发生明显变化。术后 3天TBil、DBil、AL T、AST、AL P均有不同程度升高 ,PAB均有不同程度下降 ;术后 7天趋向于恢复 ,同术后 3天比较 ,除 AL P和A、B组的 PAB外 ,均有显著性差异。γ- GT变化无规律。 A组和 C组、B组和 C组的肝功能恢复速度无显著性差别。三组的食欲、疲劳程度在术后 4天、8天均无显著性差异。结论 腺苷蛋氨酸对肝叶切除术后急性肝功能损害有保护作用 ,单独使用腺苷蛋氨酸同联合应用部?
Objective To study liver protecting effect of S adenosy L methionine(SAMe) for acute heaptic damage after hepatectomy.Methods During July and November in 2002,forty patients with liver tumour in special treatment department of eastern hepatobiliary surgery hospital underwent liver protecting theraphy after hepatectomy with clamping the first porta hepatis.The cases were divided into three groups;group A (n=10),SAMe and Diammonium Glycyrrhizinate;group B(n=10),SAMe,Diammonium Glycyrrhizinate and Matrini;and group C(n=20),SAMe alone.Drugs had been used from operation day to postoperative day(POD)7.No other liver protecting drug was given except Fructose Diphosphate Sodium(FDP).Some serum indexes including total bilirubin(TBil),direct bilirubin(DBil),alanine aminotransferase(ALT),aspartate aminotransferase(AST),L γ glutamyltransferase(γ GT),alkaline phosphatase(ALP),and prealbumin(PAB) were detected on POD 3 and POD 7.Food appetite and fatigue of all the cases were evaluated on POD 4 and POD 8.Results All those indexes changed markedly after hepatectomy.TBil,DBil,ALT,AST and ALP rose to a certain extent while PAB decreased on POD 3 in three groups.On POD 7,those indexes inclined to recover and had a significant difference compared with those on POD 3 except ALP in three groups and PAB in group A and group B.γ GT varied with no regularity in all groups.The recovery speed of liver function in both group A and group B had no significant difference compared with that in group C.There was no notable difference for food appetite and fatigue in three groups on POD 4 and POD 8.Conclusions The liver protecting effect of SAMe for acute hepatic damage after hepatectomy is sure.With the comparison of other liver protecting drugs used at the same time,SAMe used alonge have a similar effect.
出处
《肝胆外科杂志》
2003年第6期422-424,共3页
Journal of Hepatobiliary Surgery
