围手术期血清胆碱酯酶评估肝硬化肝脏储备功能的临床意义

目的　分析围手术期血清胆碱酯酶评估肝硬化肝脏储备功能的临床意义。方法　对吉林大学中日联谊医院 1996年～ 2 0 0 3年间肝硬化患者 2 4 8例、门奇静脉断流术 113例的病人进行回顾性分析。结果　随着肝脏功能的下降 ,血清胆碱酯酶活性也出现相应的降低。术前血清胆碱酯酶活性低于 190 0u/L时 ,有 5例患者术后出现肝昏迷。结论　血清胆碱酯酶活性与慢性肝病肝脏的严重程度相一致 ,因其具有受肝脏以外因素影响小、半衰期短 (仅为 11天 )、检测方法简单等优点 ,可以作为临床评价肝储备功能的手段之一。通过检测血清胆碱酯酶活性来评估肝脏储备功能可弥补传统的Child分级的不足。当血清胆碱酯酶小于 190 0u/L时手术后出现肝功能衰竭的可能性较大。

Value of serum chollnesterase(ChE)to evaluate liver reserve function incirrhotic patients in operation

Objective To observe value of serum cholinterase(ChE)to evaluate liver reservefunction in cirrhotic patients in operation. Methods Retrospective analysis of 248 cirrhotic patients and 113 cirrhotic patients undergoing pericardial devascularization in our hospital from 1996 to 2003. Results With the liver function descending, the serum ChE decreased. When preoperailve serum ChE was lower then 1900 u/L, 5 patients who had hepatic encephalopathy postoperation. Conclusion Serum ChE changes with the severlty of cirrhotic liver. Because it is little effected by other factor without liver and half life is short and method of check is simple, it can be one of the methods toevaluate the reserve function of cirrhotic liver. Using serum ChE to evaluate hepatic reserve function can make up of Child grade. If the preoperative serum ChE is lower then 1900 u/L, liver failure maybehappen.