肝脏能量代谢与手术后多器官衰竭的关系

Hepatic energy metabolism and postoperative organ failure

作者对１６９例经历了外科大手术后的患者进行了动脉血酮体比率（ＫＢＲ）的观测，并与术后临床过程进行了比较分析。根据术后ＫＢＲ变化将全部患者分为三组：Ａ组１０２例，术后ＫＢＲ一直保持于０．７以上；Ｂ组６１例，术后ＫＢＲ曾一度降至０．４～０．７；Ｃ组６例，术后ＫＢＰ逐渐下降到０．４以下。术后Ａ组２例发生器官衰竭（２．０％）；Ｂ组２０例发生２６个器官衰竭（３２．８％）．但随ＫＢＲ的回升并发症亦缓解；而Ｃ组６例患者均死于多器官衰竭。作者认为ＫＢＲ是评价肝脏能量代谢的可靠指标，同时证明肝脏能量代射障碍在多器官衰竭的发生中起到了关键性的作用。

Abstract Postoperative arterial blood ketone body ratio (KBR)was compared with the clinical course in 169 cases undergoing major surgery,all patients were divided into three groups. In group A (102 patients) the KBR was 0. 7 or up. In group B (61 patients) the KBR was temporarily decreased to between O. 4-0.7 and then increased to 0.7 and up. Group C was characterized by persistent low KBR (below0.4). Postoperative organ fail ure developed in 2 patients (2.0% )in group A ,in 20 in group B (32. 8%),and in 6 (100%)in group C,,respectively. It is the authors belief that KBR an indicator of hepatic energy metabolism plays important role in the prognosis of surgical patients.