2014jan一篇用于肝脏术后功能恢复.pdfVIP

1.Hepatogastroenterology.2013Jul-Aug;60(125):1136-41.doi:10.5754/hge11072.

BeneficialeffectsofS-adenosyl-L-methionineonpost-hepatectomyresidualliverfunction:a

prospective,randomized,controlledclinicaltrial.

SuZR,CuiZL,MaJL,LiJS,GeYS,YuJH,PanJH,XuGL,JiaWD.

BACKGROUND/AIMS:

Hepatectomyisassociatedwithhighratesofpostoperativeliverdysfunctioninpatientswith

cirrhosis.SinceS-adenosyl-L-methionine(SAMe)canbeusedtotreatliverdisease,we

performedaprospectiveclinicaltrialtoinvestigatewhetheritcouldbeusedafterhepatectomy

tobenefitresidualliverfunction.

METHODOLOGY:

Westudied79hepatitis-relatedchronicpatientswhounderwentresectionofhepatocellular

carcinoma;39patientswererandomlyassignedtoreceivepostoperativeintravenousSAMe

treatment,and40wererandomlyassignedtoacontrolgroup.ThepostoperativeSAMe

treatmentconsistedofSAMe1,000mggivenintravenouslyforsevendays.Theothertreatment

wasstandardized.

RESULTS:

Atinclusionintothetrialnosignificantdifferenceswereobservedbetweenthetwogroupswith

respecttogender,age,Childclassification,preoperativeliverfunctiontests,bloodloss,total

timeofhepaticpedicleocclusionandtheextentofliverresection.Theoverallfrequencyof

postoperativeliverinsufficiencydecreasedfrom42%inthecontrolgroupto31%intheSAMe

group,althoughnotstatisticallysignificant(p=0.121).Whenthepatientswhounderwent

hepaticpedicleocclusionbyPringle’smaneuverover15minwereanalyzed,thefrequencyof

postoperativeliverinsufficiency(p=0.028),serumtotalbilirubinlevelsondays5(p=0.025)and

7(p=0.032)preoperatively,andtheumvalueofpostoperativeserumtotalbilirubin

(p=0.040)weresignificantly