前列腺素E1对肝切除术后肝脏保护作用的临床研究

Liver protection of prostaglandin E1 in patients after hepatectomy

目的探讨肝切除术后前列腺素E1（prostaglandin E1，PGE1）对肝脏的保护作用。方法采用随机对照的方法将82例肝切除病例分为对照组（41例）和PGE1治疗组（41例，即在对照组治疗的基础上加用PGE1脂微球载体治疗），观察住院天数、术前后各项指标以及术后3d内尿量和腹腔引流量的变化。结果PGE1治疗组患者较对照组的住院天数明显缩短，中位天数为22d，明显少于对照组的26d；术后丙氨酸转氨酶（ALT）、天门冬氨酸转氨酶（AST）、总胆红素（TBIL）、白蛋白（ALB）的恢复也较对照组显著，术后3d内的尿量明显增多，腹腔引流量则显著减少。而凝血酶原时间（PT）未见明显改变。结论PGE1能有效改善肝切除术后肝功能，降低胆红素水平，并减少术后腹水的形成，缩短住院天数，而对凝血功能无明显影响，用于肝切除术后的保护是安全的。

Objective To investigate the effect on and mechansm by which prostaglandin E1 （PGE1） protects liver functions after hepatectomy. Methods In this study, 82 cases undergoing hepatectomy were divided randomly into control group with conventional therapy （41 cases）, and PGE1 treatment group （41 cases） treated with liposomal prostaglandin E1 in addition to conventional therapy. Postoperative hospital days, urinary volume and abdominal drainage volume were observed. Pre- and postoperative liver functions were measured. Results Postoperative hospital days （median time 22 days） in PGEa treatment group were significantly shorter than those （ median time 26 days） in control group. The postoperative levels of alanine transaminase, aspartic transaminase, total bilirubin and albumen in PGE1 treatment group recovered to preoperative levels more quickly, than control group. Postoperative urinary volume in patients of PGE1 treatment group was significantly more than that in control group, while abdominal drainage volume was markedly less, although there was no significant difference in prothrombin time between the two groups. Conclusion In patients undergoing hepatectomy, PGE1 is very useful and safe to protect and improve hepatic function, decreasing the level of bilirubin, preventing ascites, formation shortening hospital days, without causing prolongation of prothrombin time remarkably.