腹腔镜手术再灌注肝损伤与损伤修复的临床研究

Clinical Research on Laparoscopic Hepatic Ischemia Reperfusion Injury and Its Repair

目的研究分析腹腔镜手术再灌注肝损伤与损伤修复在治疗慢性结石性胆囊炎的临床应用。方法随机选取该院于2012年8月—2014年7月收治的慢性结石性胆囊炎患者,随机分为实验组和对照组两组,实验组患者在术前1 d、2 h、术后1、2、3 d给以药物干预,对照组不做任何干预措施,两组患者都定时抽取空腹外周静脉血液送检,记录与检测手术基本指标(出凝血时间、手术时间以及手术费指标共11项,对比分析两组数据。结果两组患者手术的出凝血时间、手术时间、气腹压力、气腹时间和手术费用等基本指标对比,差异无统计学意义(P>0.05),且不会增加患者手术经济负担。结论腹腔镜手术中辅助药物修复再灌注肝损伤具有较高的安全性,药物川芎嗪与七叶皂苷钠不会改变患者的出凝血时间、气腹压力和气腹时间,最终也不会增加患者手术经济负担。

Objective To study the effect of laparoscopic hepatic ischemia reperfusion injury repair in the treatment of patients with chronic calculous cholecystitis. Methods Patients with chronic calculous cholecystitis admitted in our hospital from August 2012 to July 2014 were randomly divided into experimental group and control group. Drug intervention 1d, 2h before and 1d, 2d, 3d after the operation was performed for patients in the experimental group, while not for patients in the control group. The detection of fasting peripheral venous blood extracted by timing was done for all the patients. 11 indexes including coagulation time and bleed-ing time（s）, operation time（min）, operation expense, etc. were recorded and compared between the two groups. Results There were no statistically significant differences between coagulation time and bleeding time, operation time, pneumoperitoneum pres-sure, pneumoperitoneum time and operation expense of the two groups（P〉0.05）, therefore economic burden of the patients in the experimental group was not worse than that of the patients in the control group.. Conclusion Auxiliary medicines（tetramethylpyrazine,aescin, etc.） in the repair of laparoscopic hepatic ischemia reperfusion injury has high safety, can not change the coagulation time and bleeding time, pneumoperitoneum pressure, pneumoperitoneum time, and can not increase the operation expense.