半肝和全肝血流阻断下肝叶切除术后肝功能变化的比较研究

Alteration of postoperative liver functions between half and total liver vascular occlusion for the lobectomy

目的 探讨半肝血流阻断和全肝血流阻断下行肝叶切除手术后的肝功能变化。方法 病人分为两组 :半肝血流阻断组 (HLO ,n =2 8) ;全肝血流阻断组 (TLO ,n =3 5 )。测定两组病人术前及术后 1、2、3和 5d的血清白蛋白、胆红素、胆碱脂酶、sGPT水平及体温和心率变化。结果 与TLO组比较 ,HLO组入肝血流阻断平均时间明显延长 (P <0 .0 5 ) ;术后sGPT及胆红素水平明显低于全肝组 (P <0 .0 5 )。术后 1～ 3d的体温及心率也明显低于TLO(P <0 .0 5 )。结论 半肝血流阻断下行肝叶切除手术具有阻断时间长 ,肝功能损害轻的优点。

Objective To investigate the alteration in liver functions after temporary occlusion of half or total liver blood flow for the lobectomy.Methods The patients were divided into two groups;half liver occlusion group(HLO,n=28);total liver occlusion group(TLO,n=35).Serum albumin,sGPT,bilirubin and CHE were measured preoperatively and on 1,2,3,5 days postoperatively.Temperature and pulse were also observed in the meantime.Results the mean duration of interrupt blood flow in HLO group was significantly longer than that TLO group(P<0.05).Postoperative sGPT and bilirubin levels in HLO group were remarkably lower than in TLO group(P<0.05).Temperature and pulse on 1,2,3 days postoperatively in half liver occlusion group were notably lower than that in TLO group(P<0.05).Conclusion Half liver vascular occlusion has the advantages of both better tolerance to ischemia and slighter liver function injury for the lobectomy.