不同肠道准备方法对肝癌术后血清胆红素值影响的临床研究

Clinical study on influence of different intestinal tract preparations on serum bilirubin value in patients after undergoing liver carcinomectomy

[目的]探讨术前不同肠道准备方法对肝癌术后血清胆红素值的影响。[方法]将120例原发性肝癌病人随机分为A、B、C、D 4组,分别采用25%硫酸镁(A组)、磷酸钠盐口服溶液(B组)、聚乙二醇电解质散(C组)、乳果糖口服溶液(D组)作为肠道准备药物,每种药物分为单纯口服药物(A1、B1、C1、D1)与口服药物+清洁灌肠(A2、B2、C2、D2)两个亚组,比较各亚组术前和术后第1天、第3天、第5天、第7天血清胆红素值变化。[结果]单纯口服药物亚组中,A1、B1、C1、D1组术后第7天各组间间接胆红素(IBiL)、总胆红素(TBiL)值比较差异具有统计学意义(P<0.05),A1组术后第5天IBiL值明显低于B1组(P<0.05);口服药物+清洁灌肠亚组中,术后第3天A2组胆红素值均低于B2组(P<0.05);单纯口服药物与口服药物+清洁灌肠对应的亚组术后血清胆红素值比较差异无统计学意义(P>0.05)。[结论]手术可致肝癌病人术后血清胆红素升高;不同药物口服+清洁灌肠对肝癌术后血清胆红素值有一定影响;应用硫酸镁行肠道准备能在一定程度上促进术后胆红素值恢复。

Objective：To probe into the influence of different intestinal tract preparations on serum bilirubin in patient safter undergoing liver carcinomectomy.Methods： A total of 120 patients with primary liver cancer were randomly divided into 4 groups and respectively received 25% magnesium sulfate（group A）,sodium phosphate oral solution（group B）,polyglycol-electrolyte powder（group C） and lactulose oral solution（group D） as different intestinal tract preparation regimens.Each drug was divided into two sub-groups of oral drug taking simply（A1、B1、C1、D1） and oral drug taking plus cleansing enema（A2、B2、C2、D2）.Then bilirubin values of different sub-groups on day 1,3,5,and 7 before and after operation were compared.Results：There were statistical significant differences on the 7th day after operation in terms of the IBiL and TBiL levels of patients among sub-groups A1,B1,C1,and D1 who had orally taken drug simply（P〈0.05）.And the IBIL levels of group A1 cases on the 5th day were lower than that of group B1 cases after the operation.There were statistical significant differences between them（P〈0.05）.The TBIL、DBIL、IBIL values of among oral drug taking plus cleansing enema groups（A2、B2、C2、D2） cases,group A2 cases on the 3rd day were lower than that of group B2 cases after the operation.And there were statistical significant differences between them（P〈0.05）.There were no statistical significant differences in terms of the bilirubin values after the operation between the subgroups cases of oral drug taking simply and subgroups cases of oral drug taking plus cleansing enema（P〉0.05）.Conclusion：The operation itself of liver cancer patients can be lead to their postoperative hyperbilirubinemia.Different drugs of oral intestinal lavage for intestinal tract preparation before liver resection have impacts on the serum bilirubin of postoperative liver cancer patients.Preoperative oral magnesium sulfate for intestinal tract preparation of liver cancer patients can promote early bilirubin value recovery to some extent.