摘要
目的探讨脉搏染料光密度法吲哚氰绿(PDD-ICG)排泄试验评估肝储备功能的价值。方法对我院2007年3月至2008年2月间收治的75例因肝癌行肝切除术的患者行前瞻性研究,根据术后肝功能代偿情况分组,比较不同组间术前检查指标的差异;并根据ICG清除率(K)值和ICG15min储留率(R15)值再分别分组,比较各组间术后肝功能中重度功能障碍发生率的差异。结果术后肝功能轻度功能障碍组60例,中度功能障碍组12例,重度功能障碍组3例(因重度功能障碍组例数过少,纳入中度功能障碍组行统计分析)。轻度功能障碍组与中重度功能障碍组患者的年龄、术前Child-Pugh评分、PT及INR的差异均无统计学意义(P>0.05);2组间K值和R15值差异均有统计学意义(P<0.05)。将K值以0.158/min为界分为2组,K<0.158/min组术后肝功能中重度功能障碍发生率为47.1%;K≥0.158/min组为12.1%,2组间差异有统计学意义(P<0.05)。将R15值以10%为界分为2组,R15≤10%组术后肝功能中重度功能障碍发生率为15.9%;R15>10%组为41.7%,2组间差异有统计学意义(P<0.05)。结论PDD-ICG试验评估肝切除术患者肝储备功能有效、简便,对预测患者术后发生肝功能损害的程度及避免患者术后发生肝功能衰竭有重要的临床指导作用。
Objective To evaluate the effect of pulse dye-densitometry by indocyanine green test （PDD-ICG） on the assessment of hepatic function reserve. Methods Seventy-five hepatic carcinoma patients aimed to accept hepatectomy from March 2007 to February 2008 at West China Hospital were prospectively included in this study. Patients were grouped by dysfunction grade of hepatic function and the indexes before operation were compared. Furthermore, patients were grouped by K and R15 value to compare the moderate and severe liver dysfunction ratio, respectively. Results Sixty cases manifested slight liver dysfunction, 12 cases manifested moderate liver dysfunction, and 3 cases manifested severe liver dysfunction （the latter was took into moderate group due to the cases were too few）. The difference of Child-Pugh score and common liver function examination indexes such as PT and INR before operation was not significant between two groups （P〉0.05）. But PDD-ICG experiment indexes （K and R15） were remarkable different between two groups （P〈0.05）. The patients were divided into two groups according to K and R15 value, respectively. The rate of moderate and severe liver dysfunction was significant different between K〈 0. 158/min group and K≥0. 158/min group （47.1% vs. 12. 1%, P〈0.05）, and likewise moderate and severe liver dysfunction was significant different between R15≤10% group and R15〉10% group （15. 9% vs. 41. 7%, P〈 0.05）. Conclusion PDD-ICG is an effective and easy to evaluate hepatic function reserve of patient undergone hepatectomy. Therefore, it may give clinical instruction to predict and avoid the liver dysfunction after operation.
出处
《中国普外基础与临床杂志》
CAS
2009年第2期133-136,共4页
Chinese Journal of Bases and Clinics In General Surgery
