摘要
目的:研究肝癌切除术中发生肝缺血-再灌注损伤(HIRI)的患者术后使用参芪扶正注射液对机体内超氧化物歧化酶活性、丙二醛水平、肝功能等影响,明确其临床疗效。方法:收集2019年1~8月在中国人民解放军第八一医院肿瘤外科行手术治疗的肝癌患者,随机将患者分为对照组和治疗组(参芪扶正注射液),每组各20例。其中对照组1例术中改行射频治疗,1例术中仅行局部阻断,剩余38例完成研究。均行开腹肝癌切除术,且在术中均曾行Pringle法行第一肝门血流阻断;术后两组均予抗感染、保肝、抑酸、补液、静脉营养支持等常规对症治疗,治疗组,于术后当天起加用参芪扶正注射液(250 mL静脉滴注)每日1次治疗,共使用5 d。观察两组围手术期一般情况;两组于术前、术后第1天、术后第3天、术后第5天检测超氧化物歧化酶(SOD)、丙二醛(MDA)水平;检测肝功能变化(谷丙转氨酶、谷草转氨酶、乳酸脱氢酶)。结果:两组在围手术期一般情况相关指标比较,差异均无统计学意义(P>0.05);两组术前SOD、MDA水平无统计学差异,术后第1天、术后第3天、术后第5天,治疗组SOD水平高于对照组,差异均具有统计学意义(P<0.05);治疗组MDA水平低于对照组,差异均具有统计学意义(P<0.05)。两组在围手术期各阶段肝功能指标(谷丙转氨酶和谷草转氨酶)比较,差异均无统计学意义(P>0.05)。两组乳酸脱氢酶水平术后第5天比较,差异有统计学意义(P<0.05)。结论:对于在肝切除术中予第一肝门血流阻断的患者,术后使用参芪扶正注射液可以提高体内抗氧化酶活性,减少脂质过氧化物的产生,抑制HIRI过程中的氧化应激反应,从而起到保护肝脏的作用,加速术后康复。
Objective:In order to determine effects of Shenqi Fuzheng on the superoxide dismutase activity(SOD),malondialdehyde(MDA)levels and liver function of patients with hepatic ischemia-reperfusion injury during the hepatectomy so as to explore its clinical effects.Methods:Forty patients who were treated in Oncology Surgery of Bayi Hospital from January 2019 to August 2019 were enrolled and divided into control group and therapy group(Shenqi Fuzheng Injection)with 20 cases in each group.Two cases in the control group were excluded,one was switched to RF treatment during operation,the other was only partially blocked during operation,and the remaining 38 cases remained the study.These remain patients all underwent open hepatectomy with Pringle maneuver.Both groups were given anti-infection,liver protection,acid suppression,fluid replacement,intravenous nutrition support and other symptomatic treatment after surgery.For the patients in the therapy group,the treatment of Shenqi Fuzheng injection were added once a day,for 5 days.During the perioperative period,patients'general conditions,SOD and MDA levels;liver function parameters(ALT、AST、LDH)were recorded.Data were analyzed statistically by SPSS 21.0 statistical software.Results:There was no statistically significant difference in general indicators related to the perioperative period between the two groups of patients(P>0.05).Before undergoing the operation,there was no significant difference in SOD and MDA levels between the two groups(P>0.05),but at 1 d,3 d,and 5 d after operation,the SOD level in the therapy group was significantly higher than that in the control group(P<0.05)and The MDA level in the therapy group was significantly lower than the control group.The differences were statistically significant(P<0.05).There was no significant difference in ALT and AST levels between the two groups before and after surgery(P>0.05).The LDH levels in the two groups were not statistically different before surgery,on the first day after surgery,and on the third day after surgery(P>0.05),while there were statistical different on the fifth day after surgery(P<0.05).Conclusions:For patients who underwent hepatectomy with Pringle maneuver,Shenqi Fuzheng injection could improve the activity of antioxidant enzymes in the body,reduce the production of lipid peroxides,inhibit the oxidative stress response in the process of HIRI,thus it plays a role in protecting the liver and accelerated the recovery.
作者
张沥元
葛优
王轩
ZHANG Li-yuan;GE You;WANG Xuan(Department of Oncology,Bayi Hospital,Nanjing University of Traditional Chinese Medicine,Jiangsu Nanjing,210002,China)
出处
《海南医学院学报》
CAS
2021年第5期344-348,共5页
Journal of Hainan Medical University
基金
南京军区医学科技创新课题(14ZX07)。
关键词
参芪扶正注射液
手术切除
肝缺血-再灌注损伤
氧化应激
Shenqi Fuzheng injection
Surgical resection
Hepatic ischemia-reperfusion injury
Oxidative stress
