肝脏肿瘤手术患者麻醉中应用乌司他丁对肝功能以及细胞因子的影响

Impact of ulinastatin on liver function and cytokines of patients undergoing liver cancer surgery

目的分析探讨肝脏肿瘤手术患者麻醉中应用乌司他丁对其肝功能以及细胞因子的影响情况。方法选择2012年2月至2015年2月期间接受治疗的84例肝脏肿瘤切除术患者,使用随机数字表分成观察组和对照组。观察组患者于麻醉诱导后静脉注入乌司他丁,对照组患者则相应的注入同等剂量的生理盐水。比较两组患者的手术情况,切皮时和手术后1 d时的肝功能指标[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)],切皮时和再灌注30min时的丙二醛(MDA)、超氧化物岐化酶(SOD)、相关细胞因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]的水平。结果两组患者在手术情况方面比较的差异无统计学意义(P>0.05);两组患者术后的ALT和AST水平均较切皮时显著增加(P<0.05),但观察组患者的ALT和AST水平均明显低于对照组,差异具有统计学意义(P<0.05);两组患者再灌注30 min时的MDA、TNF-α和IL-6水平均较切皮时显著增加(P<0.05),但观察组患者MDA、TNF-α和IL-6水平均要明显低于对照组(P<0.05);两组患者再灌注30 min时的SOD水平都较切皮时显著减少(P<0.05),但是观察组患者的SOD水平均要明显高于对照组(P<0.05)。结论乌司他丁应用于肝脏肿瘤患者手术麻醉中,能够有效改善其肝功能指标、抑制炎症反应以及氧化应激反应,具有重要的临床意义。

Objective To analyze and discuss the impact of ulinastatin on liver function and cytokines of patients undergoing liver cancer surgery. Methods 84 cases of patients undergoing liver cancer surgery were selected,which were treated in our hospital from February 2012 to February 2015. All patients were divided into the observation group（ 42 cases） and control group（ 42 cases）. The patients of observation group were treated with ulinastatin after induction of anesthesia,and the patients of control group were treated with normal saline. The surgical case,liver function [alanine aminotransferase（ ALT）,aspartate aminotransferase（ AST） ] at skin incision and 1d after postoperative,malondialdehyde（ MDA）,superoxide dismutase（ SOD）,related cytokines [tumor necrosis factor- α（ TNF- α）,interleukin- 6（ IL- 6） ] at skin incision and 30 min after reperfusion were observed and compared. Results In the terms of surgical case,there was no significantly difference between the two groups（ P〈0. 05）. After surgery,in the terms of ALT and AST,the patients of two groups were all significantly increased than skin incision（ P〈0. 05）,but ALT and AST in the observation group of patients were significantly lower than the control group（ P〈0. 05）. At 30 min after reperfusion,in the terms of MDA,TNF- α and IL- 6,the patients of two groups were all significantly increased than skin incision（ P〈0. 05）,but the levels of MDA,TNF- α and IL- 6 in the observation group were significantly lower than the control group（ P〈0. 05）. At 30 min after reperfusion,in the terms of SOD,the patients of two groups were all significantly decreased than skin incision（ P〈0. 05）. But SOD in the observation group was significantly higher than the control group（ P〈0. 05）. Conclusion Ulinastatin can effectively improve the liver function of patients undergoing liver cancer surgery,inhibit the inflammatory response and oxidative stress of the body,which makes it have an important clinical significance.