摘要
目的 探讨临床上施行复杂的肝脏手术前增加肝细胞内糖原含量能否减轻术中因阻断肝血流所带来的肝脏缺血—再灌注损伤。方法 将近 3年我院收治的临床基本情况相近的 17例患者分为实验组及对照组。实验组患者于术前 2 4h内静脉滴注 2 5 %葡萄糖 2 5 0ml,共 4次 (1次 / 6h) ,对照组不作特殊处理。两组患者均采用阻断第一肝门方法行病变肝脏切除术。术中分别于肝脏缺血前、缺血后及再灌注 1h获取相对正常的肝组织测定组织中ATP含量 ,此外于术前及术后第 1、5d ,抽取血液标本 ,检测患者肝功能情况。结果 两组患者于缺血后及再灌注 1h ,实验组肝组织ATP含量显著高于对照组 (P<0 0 1) ;术后第 1、5d ,实验组肝功能改善程度均显著地优于对照组 (P <0 0 1) ,而术前两组间则差异不显著。结论 临床上在阻断肝脏血流施行复杂的肝脏手术之前 ,增加肝细胞内糖原含量可有效地减轻肝脏缺血—再灌注损伤程度 ,降低手术风险。
Objective To study the effect of intracellular glycogen on liver ischemia-reperfusion injury from hepatic vascular exclusion.Methods 17 patients were divided into experiment group(n=9)and control group(n=8).The patients of experiment group were injected with 250 ml of 25% glucose via vein per 6 hours during pre-operative 24 hours.The pathological liver tissue were resected by using portal triad clamping in the two groups.Hepatic tissue were biopsied to measured hepatic tissue ATP contents at the point of pre-ischemia,post-ischemia and reperfusion 1 hour.Furthermore,liver function of all patients were investigated at the point of pre-operative and post-operative 1 and 5 days.Results Hepatic tissue ATP contents of experiment group significantly were higher than that of control group at the point of post -ischemia or reperfusion 1 hour (P<0.01).Besides,liver function of experiment group were significantly better than that of control group at the postoperative 1 and 5 days (P<0.01).On the contrary,there was no difference between the two groups during pre-operation.Conclusion Before liver blood flow is obstructed in order to perform complex liver operation,intracellular abundant glycogen may reduce liver ischemia-reperfusion injury caused by hepatic vascular exclusion.
出处
《中国急救医学》
CAS
CSCD
北大核心
2001年第3期151-152,共2页
Chinese Journal of Critical Care Medicine
关键词
肝糖原
肝脏手术
肝缺血
再灌注损伤
Liver glycogen
Hepatic operation
Ischemia-reperfusion injury
