控制性降压对改善肝缺血再灌注损伤的临床分析

Clinical study on the improvement of controlled hypotension on hepatic ischemia reperfusion injury

目的通过术中控制性降压的应用探讨其对改善肝缺血再灌注损伤效果的研究。方法采用分组对照,检测研究组和对照组手术前后临床指标、血生化、炎症因子指标情况。结果(1)对照组术中出血量(109.21±21.96)mL、手术后引流量(213.54±16.65)mL,研究组术中出血量(96.58±17.81)mL、手术后引流量(196.54±18.80)mL,明显少于对照组;研究组平均住院时间(12.25±1.89)天与对照组(13.75±1.49)天比较,差异有显著性(P<0.05)。(2)研究组手术前后谷丙转氨酶、谷草转氨酶、IF-6、TNF-α变化情况明显优于对照组(P值分别为0.014、0.016、0.011、0.018),比较差异有显著性(P<0.05)。结论控制性降压对降低手术创伤、改善肝缺血再灌注损伤有明显作用,能够加速手术后康复,安全可靠,可予临床推广。

Objective To study the effect of intraoperative controlled hypotension on improving the hepatic ischemia reperfusion injury. Methods The preoperative and postoperative clinical indexes,blood biochemical indexes and inflammatory factors were tested in the study group and the control group.Results（1）The intraoperative blood loss（ 96. 58 ± 17. 81） ml and postoperative drainage volume（ 196. 54± 18. 80） ml in the study group were significantly less than those in the control group [which are（ 109. 21± 21. 96） ml and（ 213. 54 ± 16. 65） ml,respectively],average hospitalization time in the study group（ 12. 25± 1. 89） days lower than that the control group（ 13. 75 ± 1. 49） days,there was significant difference between the two groups（ P〈0. 05）.（2） Preoperative and postoperative levels of ALT,AST,IF-6,TNF-a in the study group changed significantly more than those in the control group（ P = 0. 014,0. 016,0. 011,0. 018）,there was significant difference（ P〈0. 05）. Conclusion Controlled hypotension plays an important role in reducing surgical trauma and improving hepatic ischemia reperfusion injury,it can accelerate the rehabilitation after liver surgery,and it is safe and reliable to be popularized clinically.