门脉断流手术对肝功能的影响

Perioperative Changes of Hepatic Functions in Cirrhotic Patients

３２例肝炎后肝硬化，Ｃｈｉｌｄ分级的Ｂ、Ｃ级病人，应用气管插管全凭静脉复合麻醉，在门－奇静脉断流术的术前一日及术后前８ｄ，进行肝功十项指标连续监测。结果：ＡＬＴ、ＡＳＴ术后１～２ｄ增高；ＬＤＨ术后１～７ｄ持续增高；Ｔ－ＰＲＯＴ、ＡＬＢ术后３～５ｄ明显下降。表明麻醉和手术后病肝遭到新的损害。为区别手术的影响，又分别对经腹断流组和胸腹联合断流组的肝功能分别进行统计。结果：后者的ＡＬＴ、ＡＳＴ、ＬＤＨ升高明显，历时也较长，似乎术前肝损害程度和手术是影响术后肝功的主要因素，麻醉的影响相对轻微。

hirty-two patients with cirrhosis caused by type B or C hepatitis. Portal-azygous venous devascularizationwere performed under balanced anesthesia, One day before and 1～8 days after operation,ten kinds of liver func-tions were detected. Resuluts show that ALT,AST values were elevated on the lst and 2nd postoperative days,theLDH Ievel was even higher from the lst to 7th postoperative days,the T-PROT、ALB value were even lower on the3～5th postoperative days.It suggests that liver damage was exagggerated by anesthesia and operation. In order toevaluate the effects of surgery,the patients were divided into two groups,the abdomen group and thoracola-parotomy group. The ALT 、AST、LDH were higher and lasted longer in the latter group compared with that in theabdomen group. It is concluded that liver damage is related mainly to the previous status of liver function and sur-ery. The effect of anesthesia is relatively mild.