超短波肝区预处理对肝叶切除患者肝脏缺血再灌注损伤的保护作用

The protective effect of ultrashort wave preconditioning at body surface of the liver against hepatocytes ischemia-reperfusion injuries in partial hepatectomy patients

目的探讨超短波肝区预处理对肝叶切除患者肝脏缺血-再灌注损伤的保护作用。方法 58例拟行肝叶切除的患者,随机分为对照组(A组,n=26例)和超短波肝区预处理组(B组,n=32例)。B组采用超短波治疗机,取适当大小电极于患者的肝脏体表投影区域前后对置,电极与皮肤距离2～3cm,输出调频控制在50～100 MA,无热量或微热量级,1次/d,15min/次连续3d,最后一次于术前12h进行。对照组不给予任何治疗。在肝门阻断再灌注1h、再灌注6h及再灌注24h抽取静脉血测定谷丙转氨酶(ALT)、谷草转氨酶(AST)并于再灌注1h取肝组织进行病理检测。结果与对照组比较,超短波肝区预处理组ALT、AST在上述多个时相点显著降低(P<0.05)且超短波肝区预处理组具有较轻的肝脏组织病理损害。结论超短波肝区预处理可减轻肝叶切除患者肝脏的缺血-再灌注损伤从而起到保护肝脏功能的作用。

Objective To investigate the influences on the liver ischemia-reperfusion injury by ultrashort wave preconditioning at body surface of the liver in partial hepatectomy patients.Methods 58 cases of patients with liver tumour were divided into control group(A,n=26),and ultrashort wave preconditioning group(B,n=32) at random.In group B,patient liver was preconditioned by ultrashort wave at body surface of the liver before operation for 3 days.In operation of partial hepatectomy,hepatic blood flow at the first hepatic portal was totally clamped for 10-30min and then released.On 1h,6h and 24h after reperfusion,alanine aminotransferase(ATL),and aspartaste aminotransferase(AST) were detected.Liver tissue on 1h after reperfusion was taken and examined by common paraffin sections stained with HE.Results The serum levels of ALT and AST concentrations were markedly lower in group B than those in group A(P<0.05) at many time points after liver reperfusion.Less liver tissue and hepatocyte damage were found in group B than those in group A at 1h after reperfusion.Conclusion Ultrashort wave pretreatment at body surface of the liver can protect the liver from ischemia reperfusion injury in partial hepatectomy patients.