体外循环对乙肝阳性患者肝损伤的临床观察

A clinical Study on The Effect of CABG on Liver Functions in HBsAg(+) Patients

目的 探讨HBsAg阳性 (+)患者在体外循环 (CPB)下行冠状动脉旁路移植术 (CABG)肝功能的变化。方法 依术前HBsAg检查 ,将患者分为两组 ,分别检测术前、术中、术后 2 4 ,术后 7天的谷丙转氨酶 (GPT)、总胆红素 (TBIL)。结果 CPB术后HBsAg(+)患者GPT、TBIL比HBsAg (- )患者明显升高。 结论 GABG术CPB对HBsAg(+)患者能造成一定程度的肝功能损害。对此类患者围术期应注意保肝治疗 ,术中防止CPB低灌注压 ,加强心肌保护 ,防止右心衰所致的肝淤血 。

OBJECTIVE To investigate the effect of coronary artery bypass graft (CABG) on liver functions in HBsAg(+) patients with cardiopulmonary bypass.METHEDS Coronary patients were divided in to two groups according to HBsAg.Blood samples were taken preoperatively,during the operation, 24 hours after operation, and 7 days later, for GPT and total bilirubin. RESULTS In the HBsAG(+) group, GPT and TBil were significantly higher statistically.CONCLUSION Evidence suggests CABG causes more damage to liver in HBsAg(+) patients.Adequate preoperative preparation should be instituted;intraoperatively,under perfusion should be avoided;myocardial preservation is emphasized in preventing subsequent passive congestion and minimal stored blood should be used.