肝动脉鞘切除术对肝硬变失代偿期肝功能影响的研究(附13例报告)

Study on the influence of resection of liver artery sheath upon the liver function in loss compensatory stage of cirrhosis:Report of 13 cases

目的 :研究肝动脉鞘切除术对肝硬变失代偿期肝功能的影响。方法 :1987年 1月～ 1997年 1月在为肝硬变失代偿期合并胆囊结石 48例病人作胆囊切除时为改善肝功能的目的加作肝动脉鞘切除术 13例 ,并将同期、同症、肝功分级相近仅作胆囊切除术 13例作为对照组 ,观察两组手术前后肝血氧变化 ,随访观察肝功能 2 4个月。结果 :肝动脉鞘切除组肝血氧含量和血氧饱和度术后比术前分别增加 12 .5 2 %和 10 .43% ;肝功能 级 10例中转为 级级 8例 ,另 2例血清胆红素及谷丙转氨酶下降 1/3;肝功能 级 3例中转为 级 1例 , 级 2例。对照组手术前后血氧含量和血氧饱和度、肝功能均无明显变化。结论 :肝动脉鞘切除术对肝硬变失代偿期肝功能有显著改善作用。

Objective:To Study the influence of the resection of liver artery sheath upon the liver function in the loss compensatory stage of cirrhosis Method:From january 1987 to January 1997 the author had done resection of liver artery sheath for 48 patients,which were in loss compensatory stage of cirrhosis and merged the gallstone of cholecystis During resection of cholecystis author added resection liver arteay sheath for 13 cases to improve liver function At the same time auther selected 13 patients as a contrast group,which were in same stage,same disease similar in liver function and only did cholecystectomy and observed the change of liver blood oxygen before and after operation and spent 24 months to observe the liver function Result:In the group of resection of liver artery sheath the content of liver blood oxygen and the saturability of blood oxygen after operation got a raise respectively in 12 52% and 10 43% than that before operation In 10 patients of second grade of liver function 8 patients were changed into first grade In other 2 patients the serum bilirubin and the glutamic pyruvie transaminse were dropped one third In 3 patients of third grade of liver function 1 patient changed into first grade;2 patients changed into second grade In the contrast group the content of blood oxygen,the saturability of blood oxygen and liver function had no apparent change Conclusion:The resection of liver artery sheath has the improving effect for liver function in loss compensatory stage of cirrhosis