腹腔镜胆囊切除术中气腹压力不同对人体肝脏功能的影响

Influence of different pneumoperitoneal pressures on human hepatic function in laparoscopic cholecystectomy

目的观察腹腔镜胆囊切除术中不同气腹压力对人体肝脏功能的影响。方法将97例病人分为低气腹压组和高气腹压组,比较两组间术后肝功能的变化。结果与低气腹压组比较,高气腹压组谷草转氨酶、谷丙转氨酶、总胆红素、间接胆红素升高明显,且恢复较晚,而两组血清吲哚氰绿滞留试验和动脉血酮体比值变化则差异不大。结论对于术前肝功能正常的病人,不同气腹压力对人体肝脏功能产生不同的影响,其中尤以对血清转氨酶和血清胆红素的影响较为突出,而对肝脏的储备功能和能量代谢状态却无明显影响。

Objective To investigate the influence of different pneumoperitoneal pressures on human hep- atic function in laparoseopic cholecystectomy.Methods A total of 97 patients were randomized into the low pneu- moperitoneal pressure group (group A) and high pneumoperitoneal pressure group ( group B).The changes in hep- atic function after the operation were compared between the two groups.Results The levels of glutarnic-ox- aloaeetic transaminase,glutamie-pyruvic transminase,total bilirubin,indirect bilirubin in group B significantly in- creased and restored later as compared with group A.However,the changes in levels of indocyanine-green test and arterial ketone-body ratio were not remarkable in beth groups.Condusions Different pneumoperitoneal pressure produced different influences on human hepatic function in the patients with normal hepatic function before the op- eration.In particular,the influence on serum transaminase and bilirubin was prominent but that on hepatic storing function and energy metabolism state was not.