【摘要】 目的　探讨门静脉激素疗法对肝切除术后肝功能改善的价值。方法　对照组 (n =70 )给予常规护肝处理。研究组 (n =70 )增加肝门阻断前及术后 1～ 3d经门静脉注射地塞米松治疗 ,两组于术前第 4天及术后第 4天分别测试口服葡萄糖耐量试验 (OGTT)及 15min血清吲哚氰绿潴留(retentionforindocyaninegreenat 15minutes ,R15ICG)。结果　对照组OGTT术前呈抛物线型 (P型 )4 4例中有 17例于术后变成线型 (L型 )。R15ICG由术前 2 3%± 5 %增加至术后的 2 7%± 8%。术后肝衰 2 0例 ,死亡 7例。研究组OGTT术前呈抛物线型 4 0例增加至术后的 6 1例 ,R15ICG由术前的 2 4 %± 7%下降至 14 %± 3% ,术后肝衰 5例 ,无死亡病例。两组术后的差异有显著性 (P <0 0 5 )。结论　门静脉激素疗法能显著改善术后肝功能及预防肝衰 ,OGTT及R15ICG能早期灵敏地反映肝储备功能更多还原

【Abstract】 Objective To study the value of dexamethasone via portal vein by IDDS for improvement of hepatic function after hepatectomy. Methods After hepatectomy, hepatic function was protected with routine method in 70 patients (control group) and with injection of dexamethasone through the portal vein in other 70 (experimental group). OGTT and R 15ICG were determined at the 4th day before and after the operation. Results For the control group, the number of linear type on OGTT increased from 26 preoperatively to 43 postoperatively while R 15ICG from 23%±5% to 27%±8%. Twenty patients had hepatic failure and 7 of them died of it. For the experimental group, the number of parabolic type on OGTT increased from 40 to 61 while R 15ICG decreased from 24%±7% to 14%±3%. Five patients had hepatic failure and none of them died of it. There were significant differences between the 2 groups. Conclusions Injection of dexamethasone via the portal vein by IDDS can improve hepatic function and prevent hepatic failure. Meanwhile, OGTT and R 15ICG can be used as markers for hepatic function after hepatectomy.更多还原