肝切除围手术期使用地塞米松保护肝功能的必要性及可行性研究

摘要

Objective To investigate the necessity and feasibility of using dexamethasone for perioperative protection of liver function in hepatectomy.Methods The clinical data of 256 patients receiving hepatectomy in our hospital between May 2005 and January 2008 were retrospectively analyzed.The patients were divided into the treatment group (experimental group,n=131) and control group (n=125).Dexamethasone was injected intravenously in the experimental group from the time before anaesthesia to the third day after operation.The levels of serum alanine aminotransferase (ALT),aspartic acid aminotransferase(AST),total bilirubin (TB) and albumin(ALB) were detected at different time before and after using Dexamethasone.Results In the experimental group,the levels of AST,ALT and TB on 1st,3rd and 7th day after operation were decreased as compared with the control group.The levels of AST and ALT on 3rd and 7th clay after operation were significantly lower in the experimental group than in the control (P＜0.05).The level of TB on 3rd day after operation was markedly lower in the experimental group than in the control (P＜0.05).The morbidity of ascites and hydrothorax after operation was slightly lower in the experimental group than in the control than that of the control group (P＞0.05).Conclusion Dexamethasone can alleviate the hepatic dysfunction after hepatectomy,and has protective advantage for liver function in the perioperative period of hepatectomy.%目的 探讨肝切除围手术期使用地塞米松保护肝功能的必要性及可行性.方法 以本科施行肝切除术的病人为研究对象,分成治疗组131例(使用地塞米松)和对照组125例(未用地塞米松),治疗组于手术当天,麻醉前静推10 mg地塞米松,术后1～3 d,每天静推10 mg地塞米松.在肝切除术前后不同时期检测血清丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、白蛋白(ALb)和总胆红素(TBIL),进行统计学分析.结果 术后1、3、7 d,治疗组的AST、ALT、TBIL均不同程度的低于对照组,术后3、7 d有统计学意义(P＜0.05).治疗组的胸水、腹水等的并发症发生率低于对照组,但无统计学意义.结论 在肝切除围手术期使用地塞米松对肝脏具有保护作用.