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吲哚菁绿试验术前评估脾切断流术 被引量:4

Preoperative estimation of splenectomy and devascularization with indocyanine green test
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摘要 目的探讨吲哚菁绿(ICG)试验在评估脾切断流术中的临床价值。方法对50例行脾切断流术的肝硬化门脉高压症患者的ICG、谷丙转氨酶(ALT)、总胆红素(TBIL)、白蛋白(ALB)水平进行分析。结果将ChildA级患者分吲哚菁绿15min潴留率(ICGRl5)〈20%和ICGRl5〉20%组,术后检测ALT(U/L)[1d(40.54±15.76)比(46.33±14.19),3d(29.29±11.85)比(49.83±15.16),7d(21.04±6.81)比(32.67±1.75),12d(15.21±4.43)比(18.00±2.37)]、TBIL(μmol/L)[1d(20.45±7.86)比(30.77±3.48),3d(16.41±6.71)比(46.37士11.26),7d(13.94±5.02)比(32.17±10.52),12d(11.02±4.11)比(19.65±3.90)]及ALB(g/L)[1d(1.80±5.37)比(30.45±4.08),3d(33.16±3.05)比(33.78±2.10),7d(31.17±3.19)比(29.33±1.36),12d(30.51±5.04)比(26.35±2.43)]。术后ALT、TBIL、白蛋白在时间和分组因素的交互作用以及不同时间点上、不同分组间差异均有统计学意义(P〈0.05)。ICGRl5〈20%患者比ICGRl5〉20%患者术后恢复好。结论ICG试验可作为脾切断流术术前肝功能的评估指标,并是对Child—Pugh分级的有利补充。 Objective To discuss the clinical value of indocyanine green (ICG) test in the evalua- tion of splenectomy and devascularization. Methods All the 50 patients with cirrhotic portal hypertension were analyzed for ICG, alanine transaminase (ALT), total bilirubin (TBIL) and albumin (ALB). Results The patients of Child A were stratified into the retention rate of indocyanine green 15 min( ICGR15 ) 〈 20% group and ICGR15 〉20% group, and after operation, ALT levels (U/L) were at 1st day: 40. 54 ± 15.76 vs. 46. 33±14.19; 3rd day: 29. 29±11.85 vs, 49. 83 ±15.16; 7th day: 21.04±6.81 vs. 32. 67 ± 1.75; 12th day: 15.21 ±4.43 vs. 18. 00 ±2. 37, TBIL levels (μmol/L) at 1st day: 20.45 ±7. 86 vs. 30.77 ±3.48;3rdday: 16.41 ±6.71 vs. 46.37±11.26; 7th day: 13.94±5.02vs. 32. 17±10.52; 12th day: 11.02 ±4. 11 vs. 19. 65 ±3.90, and ALB levels (g/L) at 1st day: 31.8 ±5.37 vs. 30. 45 ± 4.08; 3rdday: 33.16±3.05 vs. 33.78 ±2.10; 7th day: 31.17 ±3. 19 vs. 29.33 ±1.36; 12th day: 30. 51 ± 5.04 vs. 26. 35 ± 2.43. There were significant differences ( all P 〈 0. 05 ). The prognosis of pa- tients with ICGR15 〈20% was more satisfactory than in those with ICGR15 〉20%. Conclusion ICG test can be used to evaluate the liver functions of patients receiving splenectomy and devaseularization, and is the beneficial supplement to Child-Pugh grade.
出处 《中华实验外科杂志》 CAS CSCD 北大核心 2013年第4期839-841,共3页 Chinese Journal of Experimental Surgery
关键词 肝硬化门脉高压症 吲哚菁绿试验 脾切断流术 Cirrhotic portal hypertension Indocyanine green test Splenectomy and devascu- larization
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