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孕期血红蛋白水平与妊娠高血压疾病的关系
妊娠高血压疾病(pregnancy induced hypertension,PIH)是一组常见的妊娠期特有疾病,临床表现为高血压、蛋白尿、浮肿,严重者可能发生PIH心脏病,胎盘早剥,肺水肿,凝血功能障碍,脑出血,急性肾功能衰竭,溶血、肝酶升高及血小板减少综合征(syndrome hemolytic anemia,elevated liver function and Iow platele count syndrome,HELLP),产后出血及产后血液循环衰竭等并发症[1].
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To observe the effect of Shuangcao Tuihuang Granule-1 (SCTH-1) in treating severe jaundice of acute icterohepatitis and to study its mechanism. Methods: Thirty-four patients with severe jaundice of acute icterohepatitis were treated with conventional western medicine and SCTH-1, the therapeutic effects were analyzed and compared with that in the control group (treated with western medicine alone). In the animal experimental studies, the influences of SCTH-1 on acute liver injury, liver superoxide dismutase (SOD) and serum ALT and AST in mice were monitored. Results: The markedly effective rate in the treated group and the control group was 73.5% and 59.1% respectively, and the effective rate was 23.5% and 40.9% respectively. The markedly effective rate in the treated group was obviously higher than that in the control group (P<0.05). Experimental study showed that SCTH-1 could reduce the level of serum transaminase and liver tissue damage in mice with acute liver damage. In addition, SCTH-1 could raise the activity of liver SOD (P<0.05). Conclusion: SCTH-1 could accelerate the jaundice subsidence, improve the liver function and ameliorate the liver injury, its mechanism was possibly correlated with raising SOD activity and scavenging oxygen free radicals.
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谷氨酰胺二肽对全肠外营养短肠综合征大鼠血清蛋白及肝功能的影响
目的观察谷氨酰胺二肽对Wistar大鼠短肠模型血清蛋白和肝功能的影响,及其减轻脂肪乳剂引起肝损害的作用机理.方法32只Wistar雄性大鼠随机分为谷氨酰胺二肽组(Gln-TPN组)、标准组(Std-TPN组)、无氮组,观察不同组动物之间血清总蛋白、白蛋白、前白蛋白(PA)、纤维结合蛋白(FN)以及谷丙转氨酶和胆红素的变化.结果Gln-TPN组血清总蛋白、纤维结合蛋白与Std-TPN组相比无明显差别,但高于无氮组(P<0.05),白蛋白、前白蛋白明显高于Std-TPN组和无氮组(P<0.05);谷丙转氨酶、总胆红素和直接胆红素三组之间均有差别,Gln-TPN组低(P<0.05).结论谷氨酰胺二肽能提高短肠综合征大鼠血清蛋白、前白蛋白的含量,抑制全肠外营养(TPN)引起的肝内淤胆作用,减轻脂肪乳剂对肝功能损害,增强其生存能力.
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卵磷脂治疗伴有肝功能不良的老年高脂血症的临床研究
目的评价卵磷脂治疗伴有肝功能不良的老年高脂血症的临床疗效及安全性.方法47例原发性高脂血症患者,均伴有肝功能不良,服用卵磷脂3粒,3次/d,治疗共8周,分别于治疗前、治疗后第4、8周测定谷丙转氨酶(ALT)、血肌酐(CREA)、总胆固醇(TC)、总甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C),并计算动脉硬化指数(A1).结果经卵磷脂治疗后,TC、TG、LDL-C、ALT、CREA、AI均显著下降,而HDL-C显著升高.结论卵磷脂具有调节血脂的作用,同时还能改善肝功能,在临床应用中具有广阔的前景.
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腹腔镜胆囊切除术中应用电凝钩止血对肝功能的影响
目前,随着腹腔镜技术在全世界范围内广泛开展,腹腔镜胆囊切除术(laparoscopic cholecytectomy,LC)后人体肝功能的变化已引起人们的关注[1].很多术者多采用电凝钩"一钩到底",这可能对肝脏产生影响.针对这一问题我们对分别使用电凝钩和电凝棒进行胆囊床止血病人的肝功能进行比较研究,现将结果报告如下.
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外源性双歧杆菌对肠道外营养模型兔肠道微生态的调节作用
近年来研究表明肠道微生态失调是全静脉营养(TPN)相关胆汁淤积的重要病因,TPN时肠屏障功能降低及肠菌移位是TPN相关胆汁淤积发生的重要机制[1].
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痔血胶囊致肝功能损害1例
病例:患者,男,68岁.在外院行肛瘘手术后,在家自服红霉素肠溶胶囊(1次500mg,每日2次,约7天)及痔血胶囊(四川维奥制药有限公司生产,1次0.84g,每日2次,约40天)治疗,同时使用复方角莱酸酯栓(规格:3.4g,每日2粒,约7天)外用.用药过程中,患者逐渐出现乏力、纳差、恶心、呕吐、尿黄等症状,遂来我院诊治.患者无肝炎病史,检验结果示:乙肝HBsAb、HBeAb、HBcAb抗体阳性,HBVDNA阴性,甲、丙、丁型肝炎抗体阴性,不支持病毒性肝炎的诊断.
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Objective To investigate the efficacy of hematopoietic stem cell (HSC) transplantation via the hepatic artery vs. the portal vein for end-stage liver disease (ESLD).
Methods Patients with hepatic decompensation were prospectively recruited from September 2010 to September 2012 to receive HSC transplantation via the hepatic artery or the portal vein. Liver function was examined at 3, 6, and 12 months after transplantation. Liver biopsy results were analyzed using the Knodell score.
Results Eighty patients (58 males and 22 females) were enrolled in the study. The Child-Pugh score was grade B in 69 cases, and grade C in the remaining 11 cases. HSC transplantation was performed via the portal vein in 36 patients and via the hepatic artery in 44 patients. ALT levels decreased while serum albumin levels increased significantly in both groups at 6 and 12 months after HSC transplantation (P<0.05 compared with pre-transplantation levels). Total bilirubin levels decreased significantly in both groups at 3, 6, and 12 months after HSC transplantation (P<0.05 compared with pre-transplantation levels). Additionally, prothrombin time decreased in both groups at 12 months after HSC transplantation (P<0.05 compared with pre-transplantation level). There were no significant differences in ALT, total bilirubin and prothrombin time between the two groups either before or after transplantation. Moreover, Knodell score decreased significantly at 6 and 12 months. Histological examination showed that liver cell edema, degeneration, necrosis, and inflammation were significantly relieved at 3, 6, and 12 months after transplantation. The incidence of portal vein thrombosis, upper gastrointestinal bleeding, and hepatic encephalopathy were 1.25%, 3.75%, and 2.5%respectively.The one-year survival rate was 100%.
Conclusions Autologous HSC transplantation improves liver function and histology in ESLD patients. The administration route of HSC has no significant impact on the efficacy of transplantation. -
急性胰腺炎伴肝功能损害的临床分析
急性胰腺炎是临床上较常见的急腹症,是由于在胰腺分泌细胞内、导管系统或间质内的胰酶原过早激活引起胰腺自身消化的急性化学性炎症.
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急性重度苯胺中毒致肝功能异常1例
患者,男,28岁,某化工厂工人,2003年6月24日17时,在搬运苯胺时由于罐体突然破裂,大量苯胺液体溅于身上.当时未在意,1 h后始用清水擦洗全身.2 h后出现头晕、乏力、胸闷、恶心、颜面及全身皮肤发紫遂送某医院.
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HELLP综合征的产前护理
HELLP综合征是指妊娠高血压综合征(简称妊高征)伴有溶血(hemolysis)、肝酶升高(elevated liver function)及血小板减少(low platelet count)的一组临床症候群,是妊高征的一种严重并发症,对母婴预后有严重影响.本文对我院近10年来的30例HELLP综合征的护理进行总结,探讨对HELLP综合征的产前护理,现报告如下.
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肝硬化患者幽门螺杆菌感染后血氨浓度的变化及与肝功能的相关性
幽门螺杆菌(Hp)是一常见致病菌,其尿素酶活性可分解尿素产氨.在肝硬化患者中Hp感染率高达43%~72%.肝硬化主要临床表现为肝功能受损与门脉高压,其并发症肝性脑病是肝硬化常见的死亡原因之一,血氨升高为其常见诱因.本研究旨在观察肝硬化患者Hp感染后血氨浓度变化及其与肝功能、门脉高压的相互关系,同时观察根除Hp对血氨的影响.现将结果报道如下.
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散发性类甲型非甲非乙型肝炎临床观察
非甲非乙型肝炎国外报告可分为类甲型和类乙型.本文对经血清学分型确定的急性非甲非乙型肝炎28例,进行临床观察,并随访1~2年.其临床特征、肝功能恢复时间、转归与甲型肝炎相似,现报告如下.
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吸毒人群丙型肝炎感染率及肝功能调查
丙型肝炎起病隐匿,临床症状不明显,病程长,可达20~30年,所以一直以来不如乙型肝炎那么受人们的重视.近年来,丙型肝炎发病率逐年增长,据世界卫生组织统计,全球丙型肝炎病毒(HCV)的感染率约为3%,我国一般人群抗-HCV阳性率为3.2%[1].
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早期进食促进肝癌患者术后康复的临床护理研究
目的:探讨早期进食对促进肝癌患者术后快速康复的影响。方法随机将60例肝癌肝切除术后患者分成两组:早期进食组30例(A组),常规进食组30例(B组),比较两组患者术后肝功能、胃肠道功能恢复情况、感染率、并发症发生率、营养费用、睡眠质量及住院时间。结果早期进食组患者肠鸣音恢复时间(25.51±4.64)h、肛门排气时间(36.22±5.71)h以及首次排便时间(51.32±7.93)h与常规进食组(41.63±6.16)h,(58.44±7.94)h,(72.83±9.91)h相比有统计学差异(P<0.05);术后第1天肝功能指标差异无显著意义(P>0.05);术后第5天早期进食组谷丙转氨酶(63.22±18.76)U/L、总胆红素(20.12±5.76)μmol/L和直接胆红素(12.46±5.28)μmol/L水平较低,白蛋白(36.43±4.55)g/L水平较高,与对照组[(78.31±20.56)U/L,(25.33±6.26)μmol/L,(16.51±7.35)μmol/L,(31.91±3.66)g/L]相比差异均有统计学意义(P<0.05);两组术后平均睡眠时间(7.9±1.6)h 对(6.0±1.2)h、胃肠道不适(10%对50%)、感染率(6.67%对26.67%)、术后营养费用(1000±433.5)元对(2200±493.4)元、住院时间(7.21±2.21)d 对(8.98±3.14)d比较差异有统计学意义(P<0.05)。结论肝癌肝切除术后早期饮食营养护理计划是更好的围手术期护理方案,安全可行,值得临床上进一步扩大验证。
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丙肝病毒感染者血清乙肝病毒标志物与肝功能情况分析
乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)是引起慢性肝病的主要致病因子,并与肝硬变、肝癌的发生密切相关[1].由于这两种病毒具有相似的传播途径,所以HBV和HCV的合并感染比较常见,流行率约10%~15%[2,3].
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儿童肝外型门静脉高压症
小儿门静脉高压症临床并非少见.其发病率占本病的7~8.8%.而肝外型门静脉高压症又约占小儿病例半数之多,其病因、临床表现及治疗方法选择上与肝内型门静脉高压症皆有所别.我科自1958~1985年共收治小儿肝外型门静脉高压症17例,报道如下.
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BACKGROUND: Donor shortage is the biggest obstacle in organ transplantation. Living donor liver transplantation (LDLT) has been considered as a valuable approach to short-ening waiting time. The objectives of this study were to inves-tigate the feasibility of utilizing donors older than 50 years in LDLT and to evaluate the graft function and recipient survival.
METHODS: All LDLT cases (n=159) were divided into the older (donor age ≥50 years, n=10) and younger (donor age <50 years, n=149) donor groups. Donor graft and recipient condition pre-, intra- and post-operation were compared between the two groups. Inparticular,graftfunctionsandrecipientsurvivalswereanalyzed.
RESULTS: The median donor age was 58.5 (52.5-60.0) years in the older donor group and 25.0 (23.0-32.0) in the younger do-nor group. There was no significant difference in cold ischemic time, anhepatic phase and operation time between the older and younger donor groups (P>0.05). However, the volume of red blood cell transfused in operation was greater in the older donor group than in the younger donor group (1900 vs 1200 mL, P=0.023). The 1-, 3- and 5-year graft survival rates were 90%, 80% and 80% for the older donor group, and 92%, 87%and 87% for the younger donor group, respectively (P=0.459). The 1-, 3- and 5-year survival rates were 100%, 90% and 90%for recipients with older grafts, and 93%, 87% and 87% for those with younger grafts, respectively (P=0.811).
CONCLUSION: It is safe for a LDLT recipient to receive liver from donors older than 50 years, and there is no significant adverse effect on graft function and long-term patients' survival.