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门静脉激素疗法预防肝切除术后肝功能衰竭的研究 |
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王在国 丁福全 张爱玲 张玉萍 朱江
【摘 要】 目的 探讨门静脉激素疗法对肝切除术后肝衰的预防价值。方法 对照组(n=60)仅给予常规保肝治疗处理,研究组(n=30)另于肝门阻断前后及 术后第1~3日行地塞米松门静脉注射治疗。结果 对照组术后肝衰14例(23.3%) ,因肝衰死亡6例(10%);研究组术后肝衰2例(6.7%),无肝衰死亡。两组术后肝衰的差异存 在显著性(P<0.05)。结论 门静脉激素疗法可以降低术后肝衰的发生率。 【关键词】 肝切除术 肝衰 地塞米松 门静脉注射 预防
The preventive value of dexamethason injecting into portal vein by IDDS for he patic failure after hepatectomy
Wang Zaiguo,Ding Fuquan ,Liu Guangzhong,et al. (Department of General Surgery,Sichuan Cancer Hospital, Chendu 610041)
【Abstract】 Objective To explore the preventive value of dexamethason injecting into portal vein by IDDS for hepatic failure after hepatectomy. Methods 30 cases were treated by routine guiding liver methods and tran sfusing dexamethason before and after controlling hepatic blood stream an d 1 ,2,3 day after operation through IDDS which were inserted into portal vein and implanted under the skin of abdominal wall as the experimental group.60 cases w ere only treated by routine guiding liver methods as the control group.All cases underwent similar hepatectomy.Results 2 cases had hepatic fail ure and no death in the experimental group,and 14 cases had hepatic failure and 6 cases died of hepatic failure in the control group.The difference was sig nifi cant(P<0.05).Conclusion The results indicate that local tr ansfusion of dexamethason through portal vein by IDDS can prevent hepatic failure. 【Key words】 Hepatectomy Hepatic failure Dexamethason Portal veint ransfusion Prevention
肝功能衰竭(肝衰)是肝切除术后主要并发症和死亡原因[1],研究其防治新方 法具有实际临床意义。本文探讨门静脉激素疗法对术后肝衰的预防价值。
1 资料和方法
1.1 临床资料 全组共90例,男81例,女9例。年龄11~69岁。均经病理诊断证实。将1996年1月至1997 年10月肝切除30例设为研究组,另将1990年1月至1995年12月60例设为对照组。两组与肝衰 相关的临床资料见表1。 1.2 方法 1.2.1 肝切除方法 两组均采取常温下第一肝门血流阻断法行不规则肝切除术,切除的 肿瘤大小、肝门阻断时间、术中出血量见表1。
表1 两组病人临床及手术资料比较
分组 例数 HBsAg(%) 肝硬化(%) 术前肝功 能(%) 肿瘤大小 (±s)cmhi 肝门阻断时间
[1] [2] [3] 下一页 上一个医学论文: 腔内人造血管内支撑术在血管外科中的应用 下一个医学论文: 肝癌射频原位灭活治疗的研究
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