激素并缺血预处理对肝硬化肝癌肝脏功能围手术期的保护作用

Perioperative protective effect of steroid and ischemic preconditioning on liver in patients with hepatocellular carcinoma and cirrhosis

目的：探讨肝脏功能处于Child B级的肝硬化肝癌患者采用激素并缺血预处理对患者肝功能的影响。方法：分析60例肝功能为Child B级的肝细胞性肝癌合并肝硬化手术切除治疗病例资料，预处理组（激素＋缺血预处理）（n=30），对照组（阻断15～20min后，给予灌注5min）（n=30）；各组患者均于手术前、手术结束、术后第1、2、3、7、14．21天及出院前测定肝脏功能中天门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、总胆红素（TBIL）、直接胆红素（DBIL）间接胆红素（IBIL）指标的变化。结果：预处理组术后肝功能受损程度较对照组明显减轻（P〈0．05）。结论：使用入肝血流阻断缺血预处理并给予甲基强地松龙预处理切肝，较单纯入肝血流阻断缺血预处理更有助于减轻手术引起的肝功能损害。

Objective： To explore and study the protective effect on the use of pre-steroids on ischemia/ reperfusion induced liver injury about the liver function in Child B class cirrhosis in hepatocellular patients. Methods ： Analysis of the sixty patients of liver function as Child B-class Hepatocellular carcinoma with cirrhosis cases of surgical resection. Such as ischemic preconditioning add Methylprednisolone Long group （group A）, and control group （group B）. Patients in both groups before operation, blocking, blocking, and after 1, 2, 3, 7, 14, 21 days after the determination of liver function transit aspartate aminotransferase （AST）, alanine aminotransferase （ALT）, total bilirubin （TBIL）, direct hilirubin （DBIL）, indirect bilirubin （IBIL） targets. Results： After the block and 1, 2, 3, 7, 14, 21 daysafter the detection of TBIL, DBIL, IBIL, AST and ALT of group A were both significantly lower than those of group B （P 〈0.05）. Conclusions： Ischemic preconditioning add Methylprednisolone Long can more reduce the surgery caused damage to liver function than simple ischemic preconditioning.