摘要
目的:评估腹腔镜辅助肝切除术(LH)和开腹肝切除术(OH)两种手术方式对患者术后肝功能的影响。方法:选择在我科行肝切除术的患者,排除不符合纳入标准的患者后,将患者随机分为LH组(51例)和OH组(59例),对比两组手术前后肝功能相关指标的变化情况。结果:LH组术后第1天、第2天和第3天血清丙氨酸氨基转移酶(ALT)水平均较OH组降低,差异均有统计学意义(P<0.05)。LH组术后第1天、第2天和第3天血清天冬氨酸氨基转移酶(AST)亦较OH组降低,差异均有统计学意义(P<0.05)。而两组在术后第7天血清ALT、AST比较,差异无统计学意义(P>0.05)。术后血清总胆红素(TBIL),直接胆红素(DBIL)和凝血酶原时间(PT)在LH组中升高显著低于OH组,差异有统计学意义(P<0.05),且这些指标在LH组恢复均快于OH组。结论:与OH相比,LH对患者术后肝功能影响较小,有利于病人术后的恢复。
Objective:Toassess the effects of laparoscopic hepatectomy(LH)and open hepatectomy(OH)on liver function of patients.Methods:From July 2016 to December 2017 in our hospital,a total 47 cases of patientsmeet the inclusion and exclusion criteria,were randomly divided into laparoscopic hepatectomy(51 in LH group)and open hepatectomy(59 in OH group).Data of pre-and post-operative liver function of two groups were compared.Results:On the first,second and third day after surgery,the postoperative medians value of ALT in LH group was significantly reduced than in OH group(113.98U/L vs 133.30 U/L,Z=-2.086,P=0.037;97.55U/L vs 189.50 U/L,Z=-2.341,P=0.019;62.66 U/L vs 109.20 U/L,Z=-2.171,P=0.030).Meanwhile,the value of AST in LH group was significantly lower than in OH group(75.70 U/L vs 141.00 U/L,Z=-2.245,P=0.025;61.25 U/L vs 147.20 U/L,Z=-3.193,P=0.001;30.85 U/L vs 51.20 U/L,Z=-2.331,P=0.020).However,the differences of aminotransferase were not statistically significant in two groups on the seventh day after surgery(P>0.05).The degree of elevations of TBIL,DBIL andPT were remarkably lower in LH group than OH group(P<0.05),as well as,all of index recovered in LH group faster than in OH group.Conclusions:Compared with OH,the effects of LH on liver function in patients are lesser,and LH is beneficial for recovery of patients after hepatectomy.
作者
林师佈
杨彦
涂伟
吴开玲
陈枫
林大宁
LIN Shi-bu;YANG Yan;TU Wei;WU Kai-ling;CHEN Feng;LIN Da-ning(Department of Hepatobiliary Pancreatic Surgery,the First Affiliated Hospital of Hainan Medical University,Haikou 570102,China)
出处
《海南医学院学报》
CAS
2019年第21期1646-1650,共5页
Journal of Hainan Medical University
基金
国家自然科学基金地区基金项目(81860514)~~
