门冬氨酸-鸟氨酸在减轻肝切除术后肝功能损害中的临床研究

目的: 探讨门冬氨酸-鸟氨酸在减轻肝切除术后肝功能损害中的作用.方法: 将120例行肝切除术的病人按照切除范围分为右半肝切除组,左半肝切除组和左外叶切除组,随后每组再随机分成两组:对照组,术后行常规护肝治疗;实验组,术后除常规护肝治疗外,从术前第1天开始至术后第10天,加用门冬氨酸-鸟氨酸.检测两组术前和术后胆红素(TB)、门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)和血氨(BA)水平.同时分析术中第一肝门阻断15 min以上和15 min以下患者的肝功能的恢复情况.结果: 第一肝门阻断15 min以上患者和右半肝切除病例中,实验组术后AST,ALT以及TB明显低于对照组,P<0.05,差异有统计学意义,并且术后1 w内肝功能恢复正常.在术中第一肝门阻断15 min以下组和左半肝切除和左外叶切除病例中,术后AST,ALT以及TB低于对照组,但P>0.05,差异无统计学意义.治疗组术后血氨均低于对照组,但与对照组相比较无显著性差异(P>0.05).结论: 门冬氨酸-鸟氨酸可减轻肝切除术后尤其是大范围肝切除术后肝功能的损害,对肝功能具有保护作用.

Clinical study of L-Ornithine-L-Aspartate for injection on alleviating dysfunction of liver after hepatectomy

Objective:To invewstigate the clnical efficacy of L-Ornithine-L-Aspartate for inmjection on alleviating dysfunction of liver after haptectomy.Methods:One hundred and twenty cases of hepatectomy were dividided according to the range of resection into right hemi-hepatectomized group,left hemi-hepatectimized and left lateral lobectomized group;each group was divided again into control group,treated with conventional therapy and experimental group,based on conventional therapy plus L-Ornithine-L-Aspartate for injection intravenously from the first day before operation to the tenth day after operation. Levels of TB,AST,ALT and BA before and after operation were determined. At the same time,the restored situation of the liver function in patients whose first porta was blocked over and below 15 min was analyzed.Results:In the experimental group of the first porta blocked over 15 min and the right hemihepatectomy,levels of AST,ALT and TB were significantly lowered than that of the control group (P<0.05). And the liver function restored one week postoperatively. In the group of the first porta blocked below 15 min,left hemihepatectomy and left lateral lobectomy,levels of AST,ALT and TB after operation were lowered than that of the control group,but P>0.05. There was no difference in statisatics. BA after operation was lowered than that of the control group. But there was no significant difference compared with the control group (P>0.05).Conclusion:L-Ornithine-L-Aspartate for injection can alleviate the hepatic dysfunction after hepatectomy,especially in large range hepatectomy,and has protective advantage for liver function.