恶性梗阻性黄疸患者围手术期肝功能损害的动态观察.pdfVIP

河南科技大学学报(医学版) 2008年3月 第26卷 第1期 恶性梗阻性黄疸患者围手术期肝功能损害的动态观察 沈裕厚，孙君军，刘伟峰，常永超，刘玉秋，钱俊甫 摘 要：目的 研究恶性梗阻性黄疸病人围手术期血清内毒素水平及肝功能动态状况。方法 治疗组(A 组)除术前一般准备外，另行每日服用中药茵陈小承气汤和生理盐水碘伏灌肠，对照组(B组)行常规术前准备。 观察两组病人术前、术后血清内毒素、肝功能。结果 入院时A、B两组病人均存在不同程度的内毒素血症和肝功 能损害，经过术前准备，术前A组血清内毒素、TBIL、ALP、ALT均有明显下降，而B组下降不明显(P0．05)。术 后两组血清内毒素和TBIL、ALP、ALT在术后均有显著降低(P0．05)，且A组下降幅度明显大B组(P0．05)。 结论 恶性梗阻性黄疸病人均存在不同程度的内毒素血症、高胆红素血症以及肝功能损害。术前应用稀碘伏灌肠 联合中药口服治疗能清洁胃肠道，降低内毒素血症并减轻肝功能损害。 关键词：恶性梗阻性黄疸；内毒素血症；肝功能；灌肠；茵陈小承气汤 中图分类号：R 575 文献标识码：A 文章编号：1672—688X(2008)O1—0017-03 Dynamic Observation of Liver Function Damage in Patients of Malignant Obstructive Jaundice in Perioperative Period SHEN Yu—hou，SUN Jun-jun，LIU Wei—feng，et al (First Affiliated Hospital of Henan University of Science and Technology，Luoyang 47 1003，China) To study the dynamic condition of endotoxin levels and liver function of the patient of malignant obstructivejaundice in the perioperative period． Methods Besides general preoperative preparation，Chinese herbs—Xiaochengqi Decoction of Orintal Wormwood was taken and normal saline iodophor diluent enema were carried out in group A．Routine preoperative preparation was excuted in group B only．The kinetic changes of serum endotoxin levels and liver function during the perioperative period． Results On admission to hospital。all patients’endotoxemia and liver function damage were found．Duration preoperative preparation，the serum endotoxin levels and the TBIL，ALP，ALT levels in group A decreased significantly(P0．05)，but those of control group B decreased a little(P0．05)．The serum endotoxin levels and TBIL，ALP，ALT levels in two groups decreased significantly(P0．05)，and those of control group A decreased more obviously than those of group B after operation(P0．05)． Conclusion The patie