【摘要】 目的观察风湿性心脏病二尖瓣置换术患者的肝功能变化。方法选取风湿性心脏病患者45例,在心肺转流(CPB)下行单纯二尖瓣置换术。检测并分析术前和术后第1、3和7天肝功能。结果术后肝功能异常者15例(A组),肝功能正常者30例(B组)。A组CPB时间[(100.0±3.0)min vs.(72.0±5.7)min]、手术时间[(3.9±0.6)h vs.(3.0±0.3)h]、ICU监护时间[(52.8±4.8)h vs.(44.2±3.3)h]和术后住院时间[(24.0±2.2)d vs.(18.4±1.0)d]均长于B组(P<0.05)。术后第1、3天,总胆红素和直接胆红素均高于术前[(21.73±18.96)μmol/L、(24.60±25.87)μmol/L vs.(12.86±10.98)μmol/L和(7.98±6.24)μmol/L、(12.78±10.67)μmol/L vs.(3.84±4.92)μmol/L](P<0.05)。结论 CPB时间是影响二尖瓣置换术患者肝功能的重要因素。更多还原

【Abstract】 Objective To observe the changes of liver functions in patients with rheumatic heart disease underwent single mitral valve replacement.Methods Single mitral valve replacement under cardiopulmonary bypass(CPB)was performed in 45 patients with rheumatic heart disease.The liver functions before and on the 1st,3rd and 7th day after operation were detected and analyzed.Results Of 45 patients,abnormal liver functions after surgery were found in 15cases(group A)and the liver functions were not significantly changed in 30 cases(group B)after operation.The CPB time[(100.0±3.0)min vs.(72.0±5.7)min],operation time[(3.9±0.6)h vs.(3.0±0.3)h],ICU stay[(52.8±4.8)h vs.(44.2±3.3)h]and postoperative hospital stay[(24.0±2.2)d vs.(18.4±1.0)d]were all longer in group A than those in group B(P<0.05).Compared to before,serum levels of total bilirubin and direct bilirubin on the 1st and 3rd day after surgery were significantly increased[(21.73±18.96)μmol/L and(24.60±25.87)μmol/L vs.(12.86±10.98)μmol/L,and(7.98±6.24)μmol/L and(12.78±10.67)μmol/L vs.(3.84±4.92)μmol/L](P<0.05).Conclusion CPB time is an important factor for postoperative liver dysfunction in the patients with rheumatic heart disease undergoing single mitral valve replacement.更多还原