对慢性乙型肝炎患者胆道探查术后肝功能损害预防的诊疗体会

The Experience of Diagnosis and Treatment for Preventing Liver Function Damage in Patients with Chronic Hepatitis B after Operative Exploration

摘要: 目的：探讨慢性乙型肝炎患者胆道探查术后的肝功能损害的原因，为此类病人术后肝功能异常的预防及治疗提供帮助。方法：回顾分析2000年7月至2018年7月两个不同地区医院142例慢性乙型肝炎患者行胆道探查术的临床资料。我们根据术后有无肝功能损害分为肝功能正常组(A组)、肝功能损害组(B组)。对两组在术前、术中、术后的情况进行对比分析。比较每组的年龄、手术时间、麻醉时间、术中出血量、治疗费用、住院时间。我们使用SPSS17统计软件进行统计分析，P < 0.05表示有统计学差异。结果：术后一共有61例出现肝功能损害，81例无肝功能正常。两组在年龄、性别、术前是否合并感染上差异无显著性(P > 0.05)，具有可比性。A组与B组在手术时间、术中出血量、治疗费用、住院时间等比较差异有显著性(P < 0.05)，A组小于B组。结论：慢性乙型肝炎患者行胆道探查术在术前、术中及术后充分采取积极有效干预措施，注意保护肝功能后才能有效的避免并发症的出现。

Abstract: Objective: To investigate the causes of liver dysfunction after biliary exploration in patients with chronic hepatitis B and provide assistance for the prevention and treatment of postoperative liver dysfunction in such patients. Methods: Retrospective analysis of clinical data of 142 patients with chronic hepatitis B underwent biliary tract exploration in two different hospitals from July 2000 to July 2018. We divided the patients into normal liver function group (group A) and impaired liver function group (group B) according to the presence or absence of liver function damage. The two groups’ condition in preoperative, intraoperative and postoperative was compared. The age of each group, operation time, anesthesia time, intraoperative bleeding, treatment costs and hospi-talization time were compared. Statistical analysis was conducted with SPSS 17.0 statistical soft-ware. P < 0.05 was considered statistically significant. Results: There were 61 cases of liver dys-function after operation, and 81 cases of normal liver function. The clinical data for the two groups, such as ages, gender and whether the two groups had combined infection before operation was no statistically significant (P > 0.05), so it could do further comparison. But the operative time, intraoperative bleeding volume, treatment costs and hospitalization time were statistically significant (P < 0.05). Conclusions: Positive and effective interventions should be taken before, during and after biliary exploration in patients with chronic hepatitis B. Paying attention to the protection of liver function can effectively avoid the occurrence of complication.