择期腹腔镜胆囊切除术前及术后的肝功能常规检测：有必要吗？
Routine testing of liver function before and after elective laparoscopic cholecystectomy: is it necessary?
作者信息
Ahmad Nasir Zaheer
机构信息
Mid Western Regional Hospital, Ennis, County Clare, Republic of Ireland.
出版信息
JSLS. 2011 Jan-Mar;15(1):65-9. doi: 10.4293/108680811X13022985131291.
BACKGROUND AND OBJECTIVES
Liver function tests (LFTs) include alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and bilirubin. The role of routine testing before and after laparoscopic cholecystectomy was evaluated in this study.
PATIENTS AND METHODS
A total of 355 patients were retrospectively analyzed by examining the LFTs the day before, the day after, and 3 weeks after the surgery. The Wilcoxon signed-rank test and Student t test were performed to determine statistical significance.
RESULTS
Alterations in the serum AST, ALT, and GGT were seen on the first postoperative day. Minor changes were seen in bilirubin and ALP. An overall disturbance in the LFTs was seen in more than two-thirds of the cases. Repeat LFTs performed after 3 weeks on follow-up were found to be within normal limits.
CONCLUSION
Mild-to-moderate elevation in preoperative LFTs may not be associated with any deleterious effect, and, in the absence of clinical indications, routine preoperative or postoperative liver function testing is unnecessary.
背景与目的
肝功能检查（LFTs）包括丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、γ-谷氨酰转肽酶（GGT）、碱性磷酸酶（ALP）和胆红素。本研究评估了腹腔镜胆囊切除术前后常规检查的作用。
患者与方法
通过检查355例患者术前一天、术后一天及术后3周的肝功能检查结果进行回顾性分析。采用Wilcoxon符号秩检验和Student t检验确定统计学意义。
结果
术后第一天血清AST、ALT和GGT出现变化。胆红素和ALP有轻微变化。超过三分之二的病例出现肝功能检查的总体紊乱。随访3周后复查的肝功能检查结果在正常范围内。
结论
术前肝功能检查轻度至中度升高可能与任何有害影响无关，并且在没有临床指征的情况下，术前或术后常规肝功能检查是不必要的。
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