摘要
目的 探讨蛋白酶抑制剂 (乌司他丁 ,UTI)对合并肝硬变的肝癌患者入肝血流阻断肝切除术后肝功能的保护作用。方法 将近期我科收治的原发性肝癌患者按抽信封法随机分为UTI组 (n =16 ) :术中静脉滴注UTI 10万单位 ,2次 /天 ,术后连续用 5d ;对照组 (n =15 )应用常规护肝药物。比较两组的肝功能变化、血清C 反应蛋白 (CRP)和皮质醇的浓度。结果 术后第 1、3及 7天 ,UTI组的AST及ALT均不同程度地低于对照组 ,术后第 3天 ,UTI组的AST、ALT和TBIL均明显低于对照组 (P<0 .0 5 ) ;术后第 1天 ,UTI组的CRP水平显著低于对照组 (P<0 .0 1) ;对照组血清皮质醇水平显著高于术前 (P =0 .0 4 6 ) ;而UTI组术后血清皮质醇水平略高于术前 ,但无统计学意义。结论 蛋白酶抑制剂乌司他丁能减轻肝硬变肝癌患者入肝血流阻断切肝术引起的肝缺血 再灌注损伤 ,并能减轻手术本身对机体的打击。
Objective To investigate whether protease inhibitor (ulinastatin, UTI) can protect liver from ischemia-reperfusion injury in hepatocellular carcinoma (HCC) patients undergoing hepatectomy after hepatic inflow occlusion. Methods A prospective randomized control study was designed. Thirty-one HCC patients undergoing hepatectomy after hepatic inflow blood occlusion were randomly divided into the following two groups. UTI group (n=16), 1×105 units of ulinastatin was given intravenously in operation, then the dosage was continuously used twice a day up to 5 days postoperatively. Control group (n=15), the patients received other liver protective drugs. Liver function, plasma C-reactive protein (CRP) and cortisol level were compared between these two groups. Results The postoperative liver function of the UTI group was significantly improved compared with the control group. For example, on the third postoperative day the aspartate transaminase (AST), alanine transaminase (ALT) and total bilirubin level in the UTI group were significantly lower than those in the control group, respectively (P<0.05). On the first postoperative day, the plasma CRP concentration in the UTI group was significantly lower than that in the control group(P<0.01). The plasma cortisol level in the control group markedly increased compared with the level before operation(P=0.046). However, there was no significant difference in the UTI group between before and after operation.Conclusion Ulinastatin can effectively protect liver from ischemia/reperfusion injury in HCC patients undergoing hepatectomy performed after hepatic inflow occlusion. Also, it can relieve the surgical stress for patients.
出处
《中国普外基础与临床杂志》
CAS
2004年第1期61-64,共4页
Chinese Journal of Bases and Clinics In General Surgery