摘要
目的:研究以肝切除术后肝功能衰竭(Post-hepatectomy liver failure,PHLF)分级为基准的针对性管理在肝癌患者肝切除术术后康复中的应用及其对肝功能及营养水平的影响。方法:选取本院2020年3月至2022年3月期间90例行肝切除的肝癌患者,随机分为对照组和观察组,对照组45例术后实施常规干预措施,观察组45例术后联合以PHLF分级为基准的针对性管理。对比两组患者肠鸣音恢复和首次肛门排气排便时间,干预前和干预1 m后血清白蛋白(Albumin,ALB)、总蛋白(Total protein,TP)、谷丙转氨酶(Alanine Aminotransferase,ALT)、总胆红素(Total Bilirubin,TBIL)、谷草转氨酶(Aspartate Aminotransferase,AST)水平,干预1 m内并发症发生情况,患者PHLF平均诊断时限。结果:观察组肠鸣音恢复时间、排气时间、排便时间均短于对照组(P<0.05);干预后,两组ALB、TP水平均升高(P<0.05),其中观察组升高幅度更大(P<0.05);干预后,对照组ALT、TBIL、AST均升高(P<0.05),观察组AST降低(P<0.05),观察组ALT、TBIL、AST低于对照组(P<0.05);两组并发症发生率差异无统计学意义;观察组PHLF平均诊断时限短于对照组(P<0.05)。结论:以PHLF分级为基准的针对性管理对肝癌肝切除术患者效果显著,能够有效促进患者术后胃肠功能恢复,改善营养状况和肝功能。
Objective:To investigate the application of targeted management based on classification of posthepatectomy liver failure(PHLF)in postoperative rehabilitation of patients with Liver cancer after hepatectomy and its effects on liver function and nutritional level.Methods:90 patients with liver cancer who underwent hepatectomy from March 2020 to March 2022 in our hospital were selected and randomly divided into control group and observation group.After surgery,45 patients in the control group were received routine intervention measures,and 45 patients in the observation group were received targeted management based on PHLF classification.The intestinal sound recovery time,exhaust time and defecation time;the levels of Albumin(ALB),Total protein(TP),Alanine Aminotransferase(ALT),Total Bilirubin(TBIL),Aspartate Aminotransferase(AST);The occurrence of complications,the mean time of diagnosis of PHLF were compared between the two groups.Results:The intestinal sound recovery time,exhaust time and defecation time in the observation group were shorter than those in the control group(P<0.05).After intervention,the levels of ALB and TP in both groups were increased(P<0.05),and the amplitudes of variation in the observation group were bigger(P<0.05).After intervention,the levels of ALT,TBIL and AST in control group were increased(P<0.05),the level of AST in observation group was decreased(P<0.05),and the levels of ALT,TBIL and AST in observation group were lower than those in control group(P<0.05).There was no significant difference in the incidence of complications between the two groups.The mean diagnostic time of PHLF in observation group was shorter than that in control group(P<0.05).Conclusion:Targeted management based on PHLF grading has significant effect on patients undergoing hepatectomy for liver cancer,which can effectively promote postoperative gastrointestinal function recovery,improve nutritional status and liver function.
作者
黄倩倩
许怡
韩依汝
Huang Qian-qian;Xu Yi;Han Yi-ru(Department of Gastrointestinal Surgery,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan,China)
出处
《四川生理科学杂志》
2023年第7期1133-1136,共4页
Sichuan Journal of Physiological Sciences
基金
河南省社发领域科技攻关项目(编号:2018335)。
关键词
肝功能
肝切除术
营养
胃肠功能
Liver function
Hepatectomy
nutrition
Gastrointestinal function
