首页|血必净联合腹腔镜胆总管探查术对复杂肝外胆管结石患者血清炎性指标及肝损伤标志物的影响

血必净联合腹腔镜胆总管探查术对复杂肝外胆管结石患者血清炎性指标及肝损伤标志物的影响

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目的 观察血必净联合腹腔镜胆总管探查术对复杂肝外胆管结石患者血清炎性指标及肝损伤标志物的影响。方法 选择2022 年3 月—2023 年9 月贵州省人民医院收治的复杂肝外胆管结石患者 92 例为研究对象，采用信封法随机分为观察组和对照组，每组46 例。对照组采用腹腔镜胆总管探查术治疗，观察组采用血必净联合腹腔镜胆总管探查术治疗。治疗 7 d 后，比较 2 组治疗前后血清炎性指标[C 反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-1(IL-1)、白介素-1β(IL-1β)、白介素-6(IL-6)]、肝损伤标志物[总胆汁酸(TBA)、α-谷胱甘肽S转移酶(α-GST)、嘌呤核苷磷酸化酶(PNP)、精氨酸酶Ⅰ(Arg Ⅰ)、谷氨酸脱氢酶(GLDH)、鸟氨酸氨甲酰基转移酶(OCT)]及术后并发症发生率。结果 治疗7d后，2 组CRP、TNF-α、IL-1、IL-1β及IL-6 水平均低于治疗前，且观察组低于对照组(P<0。01);2 组TBA、α-GST、PNP、Arg Ⅰ、GLDH及OCT水平均高于治疗前，但观察组低于对照组(P<0。01)。观察组并发症总发生率低于对照组(4。35%vs。17。39%，χ2=4。039，P=0。044)。结论 血必净联合腹腔镜胆总管探查术用于复杂肝外胆管结石患者中效果较好，可降低血清炎性指标和肝损伤标志物水平，有助于降低术后并发症发生率。
Effects of Xuebijing combined with laparoscopic common bile duct exploration on serum inflammatory indexes and markers of liver injury in patients with complex extrahepatic biliary calculi
Objective To observe the effects of Xuebijing combined with laparoscopic common bile duct exploration on serum inflammatory indexes and markers of liver injury in patients with complex extrahepatic biliary calculi.Methods Ninety-two patients with complex extrahepatic biliary calculi admitted to Guizhou Provincial People's Hospital from March 2022 to September 2023 were selected as the study objects,and were randomly divided into observation group and control group by envelope method,with 46 cases in each group.The control group was treated with laparoscopic common bile duct exploration,and the observation group was treated with Xuebijing combined with laparoscopic common bile duct exploration.After 7 days of treatment,serum inflammatory indexes(CRP,TNF-α,IL-1,IL-1β,IL-6),liver injury markers(TBA,α-GST,PNP,ArgⅠ,GLDH,OCT)before and after treatment,and postoperative complications between the two groups were compared.Results After 7 days of treatment,the levels of CRP,TNF-α,IL-1,IL-1β and IL-6 in two groups were lower than before treatment,and the levels in observation group were lower than those in control group(P<0.01).The levels of TBA,α-GST,PNP,Arg Ⅰ,GLDH and OCT in two groups were higher than before treatment,but those in observation group were lower than those in control group(P<0.01).The overall complication rate of the observation group was lower than that of the control group(4.35%vs.17.39%,χ2=4.039,P=0.044).Conclusion Xuebijing combined with laparoscopic common bile duct exploration is effective in patients with complex extrahepatic biliary calculi,which can reduce the level of serum inflammatory markers and liver injury markers,and help reduce the incidence of postoperative complications.

Complex extrahepatic biliary calculiXuebijingLaparoscopic common bile duct explorationInflamma-tory indexsMarkers of liver injuryPostoperative complication

柳扬、范伟

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550002 贵阳市,贵州省人民医院肝胆外科二部

复杂肝外胆管结石 血必净 腹腔镜胆总管探查术 炎性指标 肝损伤标志物 术后并发症

2025

10.15887/j.cnki.13-1389/r.2025.02.003

临床合理用药
河北省科学技术协会

临床合理用药

影响因子：0.799
ISSN：1374-3296
年,卷(期)：2025.18(2)