远端缺血预处理对肝脏切除术后肝功能的影响

Effect of remote ischemic preconditioning on post-operative liver function of patients undergoing hemihepatectomy

目的观察肢体远端缺血预处理(RIPC)对肝脏切除术患者术后肝功能的影响。方法 20例行肝切除术患者随机分为RIPC组:患者右上肢绑止血带,切皮即刻予以充气至压力达到26.6 kPa,维持5 min后放气至0 kPa,维持5 min,循环3次;对照组:切皮即刻右上肢绑止血带不予充气放气,维持30 min。结果与术前相比,两组术后转氨酶升高及对照组中胆红素升高(P<0.05);术后第1天,RIPC组转氨酶与胆红素低于对照组(P<0.05);两组患者均未发生严重并发症,住院天数比较差异无统计学意义;RIPC组肝组织病理学损伤减轻。结论肢体RIPC可改善肝脏切除术患者术后短期肝功能的恢复,减少缺血再灌注损伤。

function of randomized To investigate the effect of remate ischemic preconditioning （RIPC） or pst-operative liver patients undergoing hemihepatectomy. Methods Twenty patients undergoing hemihepatectomy were receiving either a RIPC protocol （3 intermittent cycles of 5 rain transient right upper arm ischemia in- duced by inflating a blood pressure cuff to 26. 6 kPa altemating with 5 min reperfusion） or control protocol （ right upper arm with no inflating for 30 min）, respectively, on the incision of skin. Results Serum levels of transami- nase in both groups and bilirubin in control were increased compared with preoperation, transaminase and bilirubin were reduced in RIPC versus control on the first day after operation. Both groups underwent no serious complica-my.