資源描述:
《精準(zhǔn)肝切除對(duì)腸道通透性的影響.pdf》由會(huì)員上傳分享,免費(fèi)在線閱讀,更多相關(guān)內(nèi)容在應(yīng)用文檔-天天文庫(kù)。
1、中國(guó)醫(yī)師雜志2014年3月第l6卷第3期JournalofChinesePhysician.March2014.v01.16。No.3·333··論著·精準(zhǔn)肝切除對(duì)腸道通透性的影響謝小豐葛建君李介秋陳磊【摘要】目的探討精準(zhǔn)肝切除對(duì)腸道通透性的影響。方法單純行肝切除的患者87例,按入院先后分為(2:1):精準(zhǔn)組(58例)、對(duì)照組(29例)。精準(zhǔn)組采用精準(zhǔn)肝臟外科技術(shù)行肝切除術(shù);對(duì)照組采用常規(guī)方法行規(guī)則性肝切除術(shù)。把腹腔滲液作細(xì)菌培養(yǎng)及檢測(cè)腹腔滲液內(nèi)毒素、D乳酸水平來(lái)反映腸通透性變化。結(jié)果精準(zhǔn)組術(shù)后住院時(shí)間、體溫、進(jìn)食及血常規(guī)恢復(fù)正常所需時(shí)間均
2、明顯短于對(duì)照組(tI>7.36,P<0.01),腹內(nèi)滲液量顯著少于對(duì)照組(t=14.17,P<0.01)。兩組術(shù)中及術(shù)后1d腹腔滲液內(nèi)毒素、D哥L酸水平均顯著高于術(shù)后5d(t≥10.41,P<0.01)。精準(zhǔn)組術(shù)后2d內(nèi)毒素、D·乳酸顯著下降,術(shù)后3d恢復(fù)至正常水平,且術(shù)后2、3d顯著低于對(duì)照組同時(shí)相(tI>9.23,P<0.01);對(duì)照組從術(shù)后3d才開(kāi)始下降,術(shù)后5d恢復(fù)正常水平。精準(zhǔn)組(5/58)腹腔滲液細(xì)菌培養(yǎng)陽(yáng)性率顯著低于對(duì)照組(13/29)(x=23.51,P<0.01)。結(jié)論精準(zhǔn)肝切除對(duì)腸道通透性的影響相對(duì)較小,患者能較快康復(fù)。
3、[關(guān)鍵詞]肝切除術(shù);腸/病理生理學(xué);內(nèi)毒素類(lèi);乳酸.TheinfluenceofpreciseliverresectiontechniquesOllintestinalpermeabilityinthediseasesneedingliverresectionXieXiaofeng,GeJianjun,LiJieqiu,ChengLei.DepartmentofGeneralSurgery,163HospitalofPeopledLiberationArmy(P),Changsha410003,China【Abstract】Objectiv
4、eToevaluatetheinfluenceofpreciseliverresectiontechniquesonintestinalpermeabilityinthediseasesneedingliverresection.MethodsEighty—sevenpatientsneedingliverresectionwererandomizedtoreceivethepreciseliverresection(n=58,PLRgroup)ortheconventionalliverresection(n=29,CLRgroup).D
5、-lactateandandendotoxininabdominalfluidweredetectedinallthepatients.Theabdominalfluidbacteriacultureswereperformed.ResultsThepostoperativehospitalizationtime,theneededtimeofbloodroutine,temperature,andoppetiteresumingweresignificantlyshorterinPLRgroupthanthoseinCLRgroup(t≥
6、7.36,P<0.01);ThepostoperativeabdominalefusionwassignificantlylessinPLRgroupthanthatofCLRgroup(t≥14.17,P<0.O1).TheabdominalfluidconcentrationsofD-lactateandendotoxininoperationoratldafteroperationweresignificantlyhigherthanthoseat5dafteroperationinbothgroups(t≥10.41,P<0.01)
7、.Thoseparametersdecreasedsignificantlyat2dafteroperation,re—turnedtothenormallevelat3dafteroperationinPLRgroup,andthoseparametersweresignificantlylowerinPLRgroupthanthoseinCLRgroupatthesametimephaseafterpostoperative2or3days(tI>9.23,P<0.01);Thoseparametersbegantodropat3daf
8、teroperation,returnedtothenormallevelat5dafteroperationinCLRgroup.Thepositiverateofabdomi