CAJ | 학술논문

目的分析巴塞罗那临床肝癌分期(BCLC)-B期行手术切除的肝癌患者的临床资料,探讨吲哚菁绿试验对于评估肝癌切除术后围手术期出现肝功能衰竭的价值.方法分析62例行吲哚菁绿试验并行非规则肝切除术的BCLC-B期肝癌患者的临床资料.评估吲哚菁绿试验15 min留滞率(ICG-R15)对于围手术期出现肝功能衰竭的价值.结果术后肝功能衰竭组与非肝功能衰竭组对比,ICG-R15、Child-Pugh分值行t检验,差异有统计学意义(P＜0.05).对ICG-R15和Child-Pugh分级分别进行x2检验,差异有统计学意义.ICG-R15对于评估术后出现肝功能衰竭的敏感性为90.0％.ICG-R15与Child-Pugh分级呈正相关(r=0.68,P＜0.01).结论 ICG-R15是评估肝脏储备功能的敏感指标,ICG-R15与Child-Pugh分级呈正相关,ICG-R15结合Child-Pugh分级能更好的评估肝脏功能,预测术后肝功能衰竭.对于BCLC-B期肝癌患者,结合术前肝脏功能的综合分析,当ICG-R15＜15％、Child-PughA级时,可行非规则肝切除术;当ICG-R15＞ 20％、Child-PughB级时,禁忌手术;介于两者之间的患者,可先行保肝治疗后,再考虑手术治疗.
목적 분석파새라나림상간암분기(BCLC)-B기행수술절제적간암환자적림상자료,탐토신타정록시험대우평고간암절제술후위수술기출현간공능쇠갈적개치.방법 분석62례행신타정록시험병행비규칙간절제술적BCLC-B기간암환자적림상자료.평고신타정록시험15 min류체솔(ICG-R15)대우위수술기출현간공능쇠갈적개치.결과 술후간공능쇠갈조여비간공능쇠갈조대비,ICG-R15、Child-Pugh분치행t검험,차이유통계학의의(P＜0.05).대ICG-R15화Child-Pugh분급분별진행x2검험,차이유통계학의의.ICG-R15대우평고술후출현간공능쇠갈적민감성위90.0％.ICG-R15여Child-Pugh분급정정상관(r=0.68,P＜0.01).결론 ICG-R15시평고간장저비공능적민감지표,ICG-R15여Child-Pugh분급정정상관,ICG-R15결합Child-Pugh분급능경호적평고간장공능,예측술후간공능쇠갈.대우BCLC-B기간암환자,결합술전간장공능적종합분석,당ICG-R15＜15％、Child-PughA급시,가행비규칙간절제술;당ICG-R15＞ 20％、Child-PughB급시,금기수술;개우량자지간적환자,가선행보간치료후,재고필수술치료.
Objective Analysis the date of patients with hepatocellular carcinoma (HCC) at the BCLC-B stage,and estimate the value of indocyanine green test (ICG) for postoperative liver failure.Methods Analysis the clinical date of 62 patients by sspss17.0 software to estimate the value of Indocyanine green test (ICG) for postoperative liver failure.Results The value of ICG-R15 and Child-Pugh classification were statistically different between the two groups (P ＜ 0.05).Using postoperative failure as outcome,ICG-R15 and Child-Pugh grading were analyzed by chi-square.The results werex2 =25.05 (P ＜0.01),x2=5.94 (P ＜0.05).The different being statistically significant.The sensitivity of ICG-R15 to estimate postoperative liver failure is 90.0％.ICG-R15 appears to be positively correlated with Child-Pugh grading.Conclusion ICG-R15 is a sensitive index to evaluate hepatic function reserve and it will be more better to estimate the rate of postoperative failure combined with Child-Pugh grading.For stage BCLC-B patients with hepatocellular carcinoma,combining with comprehensive analysis of preoperative liver functional could help making decision.When ICG-R15 ＜ 15％,Child-Pugh A stage,could have operation treatment;when ICG-R15 ＞20％,Child-Pugh B stage,no surgical treatment.