乌司他丁联合异甘草酸镁在原发性肝癌根治性切除术围术期中的应用探讨

Ulinastain combined with magnesium isoglycyrrhizinate in the perioperative period of radical resection of primary liver cancer

目的探讨乌司他丁联合异甘草酸镁在原发性肝癌根治性切除术围术期的应用效果。方法抽取2016年1月至2019年10月许昌市中心医院收治的原发性肝癌患者80例,采用随机数字表法分为研究组与对照组,每组40例,均拟行根治性切除术治疗,另对照组围术期给予异甘草酸镁,研究组在对照组基础上加用乌司他丁。比较两组血清白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、C-反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、总胆红素(TBIL)、直接胆红素(DBIL)、天冬氨酸氨基转移酶(AST)、丙氨酸氨基转氨酶(ALT)、总蛋白(TP)、白蛋白(ALB)、球蛋白(GLB)、谷氨酰转移酶(GGT)、碱性磷酸酶(ALP)水平变化和不良反应。结果研究组肝门阻断10 min后及术后1、3、7 d的IL-1β、IL-6、IL-8、CRP、TNF-α、AST、ALT、GGT、ALP均低于对照组,研究组术后1、3、7 d的TBIL、DBIL均低于对照组,研究组术后1、3、7 d TP、ALB、GLB均高于对照组,差异有统计学意义(P<0.05);两组不良反应相近(P>0.05)。结论乌司他丁联合异甘草酸镁应用于原发性肝癌根治性切除术围术期,可明显减轻术后炎症反应,保护肝功能,且安全。

Objective To explore the effect of ulinastatin combined with magnesium isoglycyrrhizate in the perioperative period of radical resection of primary liver cancer.Methods A total of 80 patients with primary liver cancer admitted to Xuchang Central Hospital from January 2016 to October 2019 were selected and divided into study group and control group using a random number table method,with 40 cases in each group.All of them were treated by radical resection,and the control group was given magnesium isoglycyrrhizate at perioperative period,while the study group was given ulinastatin on the basis of the control group.The changes of levels of serum interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-8(IL-8),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),total bilirubin(TBIL),direct bilirubin(DBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT),total protein(TP),albumin(ALB),globulin(GLB),glutamyltransferase(GGT)and alkaline phosphatase(ALP)and theadverse reactions were compared between the two groups.Results The levels of IL-1β,IL-6,IL-8,CRP,TNF-α,AST,ALT,GGT and ALP in the study group were lower than those in the control group at 10 minutes after hepatic portal occlusion,1 day,3 day and 7 day after operation,and the levels of TBIL and DBIL at 1 day,3 day and 7 day after operation in the study group were lower than those in the control group,and the levels of TP,ALB and GLB in the study group at 1day,3day and 7day after operation were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the adverse reactionsbetween the two groups(P>0.05).Conclusions Application of ulinastatin combined with magnesium isoglycyrrhizate in the perioperative period of radical resection of primary liver cancer can significantly reduce the postoperative inflammatory response,protect the liver function,and has good safety.