摘要
目的 研究梗阻性黄疸患者围手术期血浆D-乳酸的变化及临床意义。方法将25例梗阻性黄疸患者作为实验组，10例胆囊结石患者作为对照组，检测实验组和对照组患者术前1d、术后1d、3d、7d、10d、14d血浆D-乳酸含量及血清胆红素水平。结果对照组术后1d血浆D-乳酸含量明显高于术前（P〈0．05），术后7d血浆D-乳酸含量下降至术前水平（P〉0．05）。实验组术前血浆D-乳酸含量高于对照组术前（P〈0．05），实验组术后1d血浆D-乳酸含量高于术前（P〈0．05），术后3d血浆D-乳酸含量呈进行性下降（P〈0．05），术后14d血浆D-乳酸含量低于术前（P〈0．05），但仍高于对照组术前（P〈0．05）。结论血浆D-乳酸可作为评价梗阻性黄疸患者肠黏膜通透性的指标；梗阻性黄疸患者术前肠黏膜通透性增加，解除胆道梗阻有利于肠黏膜功能的恢复，术后14d肠黏膜通透性未恢复至正常水平，梗阻性黄疸患者围手术期应加强肠黏膜功能的保护。
Objective To investigate perioperative changes of plasma D - lactate in patients with obstructive jaundice, and evaluate its clinical significance. Methods Twenty - five patient with obstructive jaundice were selected as experimental group ,and 10 patients with cholecystolithiasis as control group. Plasma D - lactate test and serum bilirubin test was performed on the day before operation（ POD - 1 ） ,the 1st day after operation（ POD ＋ 1 ） ,the 3rd day after operation（ POD ＋ 3 ） ,the 7th day after operation （POD ＋ 7 ）, the 10th day after operation （POD ＋ 10 ）and l gth day after operation （POD ＋ 14 ）Resuits In the control group POD ＋ 1 plasma D - lactate level was significantly higher than that preoperation（ P 〈 0.05 ）, but POD ＋ 7 plasma D - lactate .level was decreased to that preoperation （ P 〉 0.05 ）. Plasma D - lactate level before operation was significantly increased in experimental group as compared with control group（ P 〈0.05 ）. In the experimental group POD ＋ 1 plasma D -lactate level was significantly higher than that preoperation（ P 〈 0.05 ） , and POD ＋ 3 plasma D - lactate level was declined （ P 〈 0. 05 ）. In the experimental group POD ＋ 14 plasma D - lactate level was lower than that preoperation（ P 〈0. 05 ）, but significantly higher than that before operation in control group（ P 〈 0.05 ）. Conclusion Plasma D- lactate level may be a useful marker to evaluate the degree of intestinal permeability in patients with obstructive jaundice. In obstructive jaundice, an increased intestinal permeability had been demonstrated. Relieving of biliary obstruction was favorable for the resumption of intestinal function. But intestinal permeability remained higher than normal on the 14th day after operation. In the patients with obstructive jaundice the intestinal function should be protected perioperatively.
出处
《临床外科杂志》
2009年第7期459-461,共3页
Journal of Clinical Surgery
关键词
梗阻性黄疸
肠黏膜通透性
D-乳酸
obstructive jaundice
intestinal permeability
D - lactate
