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中国癌症防治杂志

中国癌症防治杂志 ›› 2016, Vol. 8 ›› Issue (3): 158-160.doi: 10.3969/j.issn.1674-5671.2016.03.06

• 临床研究 • 上一篇    下一篇

肝切除术中阻断第一肝门对术后血清淀粉酶的影响

  

  1. 广西医科大学研究生学院;广西医科大学第一附属医院肝胆外科
  • 出版日期:2016-06-25 发布日期:2016-07-08
  • 通讯作者: 叶新平 yexinping@126.com
  • 基金资助:

    广西自然科学基金资助项目（2013GXNSFAA019138）

Impact of Pringle′s maneuver on postoperative serum amylase in patients undergoing hepa-tectomy

  • Online:2016-06-25 Published:2016-07-08

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摘要：

目的 探讨肝切除术中阻断第一肝门次数和总时间对术后血清淀粉酶水平的影响。方法 回顾性分析我院2013年1月至2015年6月收治的87例采用阻断第一肝门进行肝切除术患者的临床资料，根据术后血清淀粉酶水平，分为淀粉酶正常组和高淀粉酶血症组，比较两组阻断次数、总阻断时间、术后住院天数及住院总费用。结果 87例患者中血清淀粉酶升高29例，其中轻度升高12例，高淀粉酶血症组17例。高淀粉酶血症组肝门阻断（5.3±3.0）次，肝门总阻断时间为（73.1±47.1） min；淀粉酶正常组58例，肝门阻断（3.8±2.4）次，肝门总阻断时间为（58.0±42.7） min。两组肝门总阻断时间、术后住院天数比较，差异均无统计学意义（P=0.233、P＝0.498），肝门阻断次数、住院总费用比较，差异均有统计学意义（P=0.043、P=0.001）。结论 肝切除术中增加肝门阻断次数术后可能增加高淀粉酶血症发生，增加住院费用。

关键词: 肝切除术, 阻断第一肝门, 血清淀粉酶

Abstract:

 Objective To investigate the impact of the duration and frequency of Pringle′s maneuver on postoperative serum amylase levels in patients undergoing hepatectomy. Methods Retrospective analysis of 87 patients who underwent hepatic resection using the Pringle′s maneuver at our hospital from January 2013 to June 2015 were assigned to normal or hyperamylasemia groups based on postoperative serum amylase levels. Then the two groups were compared in terms of Pringle’s frequency，Pringle duration，and length and costs of hospitalization. Results Postoperative serum amylase levels were slightly increased in 12 patients，elevated in 29，and hyperamylasemic in 17. Pringle′s frequency was significantly longer in the hyperamylasemia group than in the normal group（5.3±3.0 vs 3.8±2.4，P=0.043），while Pringle′s duration was similar between the two groups （73.1±47.1 vs 58.0±42.7 min，P=0.233）. Length of hospitalization was similar between the two groups（P=0.498），while total cost of hospitalization differed significantly between the two groups（P=0.001）. Conclusion Pringle′s maneuver may increase risk of postoperative hyperamylasemia，which increases the total cost of hospitalization.

Key words: Hepatectomy, Pringle′s maneuver, Serum amylase