期刊文献+

肝切除围手术期使用地塞米松保护肝功能的必要性及可行性研究 被引量:4

Necessity and feasibility of using dexamethasone for perioperative protection of liver in hepatectomy
原文传递
导出
摘要 目的探讨肝切除围手术期使用地塞米松保护肝功能的必要性及可行性。方法以本科施行肝切除术的病人为研究对象,分成治疗组131例(使用地塞米松)和对照组125例(未用地塞米松),治疗组于手术当天,麻醉前静推10mg地塞米松,术后1~3d,每天静推10mg地塞米松。在肝切除术前后不同时期检测血清丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、白蛋白(ALb)和总胆红素(TBIL),进行统计学分析。结果术后1、3、7d,治疗组的AST、AI,T、TBIL均不同程度的低于对照组,术后3、7d有统计学意义(P〈0.05)。治疗组的胸水、腹水等的并发症发生率低于对照组,但无统计学意义。结论在肝切除围手术期使用地塞米松对肝脏具有保护作用。 Objective To investigate the necessity and feasibility of using dexamethasone for perioperative protection of liver function in hepatectomy. Methods The clinical data of 256 patients receiving hepatectomy in our hospital between May 2005 and January 2008 were retrospectively analyzed. The patients were divided into the treatment group (experimental group, n=131) and control group (n=125). Dexamethasone was injected intravenously in the experimental group from the time before anaesthesia to the third day after operation. The levels of serum alanine aminotransferase (ALT) ,aspartie acid aminotransferase(AST), total bilirubin(TB) and albumin(ALB) were detected at different time before and after using Dexamethasone. Results In the experimental group, the levels of AST,ALT and TB on lst,3rd and 7th day after operation were decreased as compared with the control group. The levels of AST and ALT on 3rd and 7th day after operation were significantly lower in the experimental group than in the control (P〈0.05). The level of TB on 3rd day after operation was markedly lower in the experimental group than in the control (P〈0.05). The morbidity of ascites and hydrothorax after operation was slightly lower in the experimental group than in the control than that of the control group (P〉0.05). Conclusion Dexamethasone can alleviate the hepatic dysfunction after hepateetomy, and has protective advantage for liver function in the perioperative period of hepatectomy.
出处 《中华肝胆外科杂志》 CAS CSCD 北大核心 2009年第10期731-734,共4页 Chinese Journal of Hepatobiliary Surgery
关键词 肝切除术 肝功能 地塞米松 围手术期 Hepatectomy Dexamethasone Liver function Perioperative period
  • 相关文献

参考文献14

  • 1Fingueroa I.Delpin EA.Steroid protection of the liver during experimental ischemia.Surg Gynecol Obstet,1975,140:368-370.
  • 2吕诗寿 王成恩 曹秀虎.激素对缺血肝细胞保护作用的研究[J].中华实验外科杂志,1988,5:160-162.
  • 3吴栋才.糖皮质激素应用于肝脏严重创伤中的效果评价[J].中国感染控制杂志,2004,3(2):117-119. 被引量:1
  • 4Ferrari R,Cecrni C,Curello S,et al.Role of oxygen free radicals in ischemic and reperfused myocardium.Am J Clin Natr,1991,53:215-222.
  • 5张涛,何劲松,姜立华,吕新生,扬新,吴义方.亚低温对肝缺血再灌注后超微结构的保护作用[J].中国现代医学杂志,2001,11(7):22-24. 被引量:4
  • 6闭龙秋.麻醉生理学[M].北京:中国医药科技出版社,1990.101.
  • 7王世端.肝脏疾病与麻醉[J].国外医学(麻醉学与复苏分册),1994,15(1):20-22. 被引量:6
  • 8黎螯.创伤后脏器功能不全.河北:科学技术出版社,1999:160.
  • 9Takala A.Jousela I,OlkkoIa KT,et al.Systemic inflammatoryresponse syndrome without systemic inflammation acutely ill patients admitted to hospital in a medical emergency.Clin Sci (Lond),1999,96:287-289.
  • 10De Bosscher K,Vanden Berghe W,Haegeman G.Mechanisms of anti-inflammatory action and of immunosuppression by glucocorticoids:negative interference of activated glucocorticoid receptorwith transcription factors.J Neuroimmunol,2000,109:16-22.

二级参考文献29

  • 1马钧,景炳文,杨兴易,赵良.多器官衰竭患者白细胞糖皮质激素受体和血浆皮质醇变化的观察[J].中国危重病急救医学,1995,7(6):371-373. 被引量:13
  • 2石汉平,李建珍,秦路平,缪明永,杨林,宋春桥,谭金兴,徐仁宝.失血大鼠肝、脑组织糖皮质激素受体的变化及其意义[J].中国危重病急救医学,1996,8(10):577-578. 被引量:8
  • 3黎螯.创伤后脏器功能不全.河北:科学技术出版社,1999:160.
  • 4[1]Margarit C,Martinez-Ibanez V,Tormo R,et al. Maintenance immunosuppression without steroids in pediatric liver transplantation[J]. Transplant Proc,1989,21(1 Pt 2):2230-2231.
  • 5[2]Fung JJ,Todo S,Tzakis A,et al. Conversion of liver allograft recipients from cyclosporine to FK 506-based immunosuppression: benefits and pitfalls[J]. Transplant Proc,1991,23(1 Pt 1):14-21.
  • 6[3]Padbury RT,Gunson BK,Dousset B,et al. Steroid withdrawal from long-term immunosuppression in liver allograft recipients[J]. Transplantation,1993,55(4):789-794.
  • 7[4]Czaja AJ. The immunoreactive propensity of autoimmune hepatitis: is it corticosteroid-dependent after liver transplantation?[J]. Liver Transpl Surg,1999,5(5):460-463.
  • 8[5]Trouillot TE,Shrestha R,Kam I,et al. Successful withdrawal of prednisone after adult liver transplantation for autoimmune hepatitis[J]. Liver Transpl Surg,1999,5(5):375-380.
  • 9[6]Papatheodoridis GV,Davies S,Dhillon AP,et al. The role of different immunosuppression in the long-term histological outcome of HCV reinfection after liver transplantation for HCV cirrhosis[J]. Transplantation,2001,72(3):412-418.
  • 10[7]Stegall MD,Wachs ME,Everson G,et al. Prednisone withdrawal 14 days after liver transplantation with mycophenolate: a prospective trial of cyclosporine and tacrolimus[J]. Transplantation,1997,64(12):1755-1760.

共引文献15

同被引文献32

引证文献4

二级引证文献15

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部