【摘要】目的探討重癥急性胰腺炎(SAP)時胰腺組織的誘導型一氧化氮合成酶(iNOS)、內皮素（ET1） mRNA表達狀態, 以及與血漿中NO、ET1濃度和腸道損傷的關系及丹參治療的影響。方法Wistar大鼠45只隨機分為3組:SAP模型組(A組),SAP丹參治療組(B組),假手術 組(C組),進行不同治療和觀察分析。結果A組血中淀粉酶(AML)、ET1、NO、內毒素(LPS)含量、125 I白蛋白累積指數及腹水量均顯著高于C組(Plt;0.01);與A組比較,B組胰腺ET1和iNOS mRNA表達較弱,血中AML、ET1、NO、LPS及腹水量顯著下降(Plt;0.01),125 I白蛋白累積指數較A組也有下降,但無差異(Pgt;0.05)。結論SAP時存在腸道損傷,胰腺組織ET1、iNOS mRNA的過度表達,使血中ET1、NO濃度升高,造成腸道屏障功能受損,腸通透性增加,引起內毒素血癥。丹參注射液通過減輕SAP時胰腺的病理損害程度,下調胰腺ET1和iNOS mRNA的表達,使血中ET1、NO濃度下降,對SAP及其腸道損傷有一定治療作用。
ObjectiveTo evaluate the safety and feasibility of laparoscopic hepatectomy. Methods A total of 25 patients with hepatocellular carcinoma or liver hemangioma received laparoscopic hepatectomy, and perioperative results were analyzed. ResultsOnly one patient was converted to open hepatectomy because of massive hemorrhage. Blood loss of all patients during operation ranged from 100-1 200 ml with an average of 400 ml. The total blood volume of transfusion was 200-1 000 ml (mean 400 ml) in 14 patients. The operative time was 0.8-4.0 h (mean 2.3 h). All patients had no complications such as bile leakage and infection, and discharged from hospital in 5-10 d (mean 8 d) after operation. ConclusionLaparoscopic hepatectomy is safe and feasible to some liver diseases, but should be used with caution for the patients with tumor diameter over 9 cm and hepatic large vessels invaded by cancer.