原发性肝癌术后应用糖皮质激素对肝脏功能保护的随机对照研究

POSTOPECTIVE RANDOMIZED STUDY OF STEROIDS IN THE PREVENTION OF LIVER FUNCTION DURING HEPATIC RESECTION OF THE PRIMARY LIVER CANCER

目的通过术后应用糖皮质激素评价肝脏功能的变化,判定其对肝脏功能有无保护作用。方法对60例原发性肝癌行手术治疗患者采用随机分组方法,分为对照组以及试验组,术后当天起应用氢化可的松琥珀酸钠100mg,连用5天,抽血测术前以及术后第1、3、5天肝功情况,以及术后并发症发生情况,进行统计学分析。结果在治疗组中,术后第3天以及第5天胆红素比对照组有明显下降(P<0.05);但转氨酶、白蛋白等肝功能情况以及术后并发症发生情况无统计学差异。结论原发性肝癌术后应用糖皮质激素治疗可以降低术后胆红素水平,对肝脏功能可以起到保护作用。

Objective The aim of this prospective,randomized study was to determine whether steroid administration may reduce liver injury and protect the liver function.Methods Sixty patients undergoing liver resection were randomized to a steroid group or a control group.Patients in the steroid group received 100 mg of hydrocortisone postoperatively once a day for 5 days,Serum levels of alanine aminotransferase（ALT）,aspartate amminotransferase（AST）,total bilirubin,albumin were compared between the two groups.Length of stay and type and number of complications were recorded as well.Results Postoperative serum levels of total bilirubin were significantly lower in the steroid group than in controls at postoperative days 3 and 5,No differences were found in the ALT、AST、albumin and incidence of postoperative complications.Conclusion These results suggest that steroid may reduce the lever of total bilirubin,and the steroid has protective effect during the liver resection.