乌司他丁对肝癌患者大范围肝切除术后肝功能保护作用的临床研究

The protective effects of ulinastatin on liver function in patients with liver cancer after major hepatectomy

目的探讨乌司他丁对大范围肝切除术后肝癌患者肝功能的影响。方法回顾性分析232例大范围肝切除肝癌患者的临床资料。根据术后应用乌司他丁情况,分为治疗组(105例)和对照组(127例),对两组患者术后炎症因子、肝功能指标、术后并发症、住院天数进行对比分析。结果术后3 d治疗组患者炎症指标和肝功能指标水平明显低于对照组,差异有统计学意义(CRP:t=4.520,P=0.000;IL-6:t=17.982,P=0.000;TBIL:t=9.843,P=0.000;ALT:t=11.913,P=0.000;AST:t=4.520,P=0.000)。治疗组患者大量腹水发生率(χ^2=4.212,P=0.040)及术后平均住院时间(t=9.994,P=0.000)明显低于对照组,差异有统计学意义。结论连续应用乌司他丁可有效抑制大范围肝切除术后肝癌患者炎症因子的生成,保护肝功能,降低大量腹水发生率,缩短术后住院时间。

Objective To investigate the effects of ulinastatin on liver function in patients with liver cancer after major hepatectomy.Methods The clinical data of 232 patients with major liver resection due to liver cancer were retrospectively analyzed.According to whether ulinastatin was applied after operation,patients were divided into treatment group(105 cases)and control group(127 cases).The postoperative inflammatory factors,liver function,postoperative complications and hospital stay were compared.Results The levels of CRP、IL-6 and TBIL、ALT、AST were significantly lower than the control group 3 days after surgery(CRP:t=4.520,P=0.000;IL-6:t=17.982,P=0.000;TBIL:t=9.843,P=0.000;ALT:t=11.913,P=0.000;AST:t=4.520,P=0.000).The incidence of massive ascites in the treatment group(χ^2=4.212,P=0.040)and the average postoperative hospital stay(t=9.994,P=0.000)were significantly lower than that in the control group.Conclusion Early application of ulinastatin effectively inhibits the inflammatory process,protects liver function,reduces the incidence of massive ascites,and shortens the postoperative hospital stay.