CAJ | 학술논문

肝储备功能参数是评估肝脏代谢作用是否正常的关键指标，也是判断切除肝叶手术能否进行的重要依据。当前临床上获取肝储备功能参数是通过脉搏色素分光光度法测量吲哚菁绿色素浓度实现的，但是该方法需要假设血氧值为100％，这将导致肝储备功能参数的计算值存在一定误差。针对这一问题，提出了一种抗血氧波动干扰的肝储备功能参数测量方法，以修正的朗伯‐比尔定律为理论基础，实现了对脉搏色素分光光度法测量的吲哚菁绿色素浓度的修正。在人体注入吲哚菁绿后，利用自制的数据采集单元在指端皮肤处同步采集805和940 nm的双波长透射信号，以及730，805和890 nm的三波长反射信号，将收集到的五组数据依次上传至计算机，利用接收到的数据和人体注射色素前的血氧值绘制出吲哚菁绿色素的浓度曲线，并计算其特征参数，根据浓度曲线的特征参数计算出肝储备功能参数。以有效肝脏血流量为例，将所提出的方法和脉搏色素分光光度法的测量结果分别跟目前测量有效肝脏血流量最准确的电磁流量计法的测量结果相比较，测量误差得到了明显的改善。实验结果表明，该方法提高了肝储备功能参数测量的精确度，为临床提供了一种更加准确的肝储备功能参数检测方法。
간저비공능삼수시평고간장대사작용시부정상적관건지표，야시판단절제간협수술능부진행적중요의거。당전림상상획취간저비공능삼수시통과맥박색소분광광도법측량신타정록색소농도실현적，단시해방법수요가설혈양치위100％，저장도치간저비공능삼수적계산치존재일정오차。침대저일문제，제출료일충항혈양파동간우적간저비공능삼수측량방법，이수정적랑백‐비이정률위이론기출，실현료대맥박색소분광광도법측량적신타정록색소농도적수정。재인체주입신타정록후，이용자제적수거채집단원재지단피부처동보채집805화940 nm적쌍파장투사신호，이급730，805화890 nm적삼파장반사신호，장수집도적오조수거의차상전지계산궤，이용접수도적수거화인체주사색소전적혈양치회제출신타정록색소적농도곡선，병계산기특정삼수，근거농도곡선적특정삼수계산출간저비공능삼수。이유효간장혈류량위례，장소제출적방법화맥박색소분광광도법적측량결과분별근목전측량유효간장혈류량최준학적전자류량계법적측량결과상비교，측량오차득도료명현적개선。실험결과표명，해방법제고료간저비공능삼수측량적정학도，위림상제공료일충경가준학적간저비공능삼수검측방법。
Hepatic functional reserves parameters are the key indictors to assess if the hepatic metabolic function is normal ,they are also the important basis to a successful hepatectomy .Currently clinical hepatic functional reserves parameters are achieved through Indocyanine Green (ICG) concentration measurement in the method of pulse dye spectrophotometry ,with the assump‐tion that blood oxygen saturation is 100% ,this hypothetical bias leads to an error in the calculated value of the hepatic functional reserves parameters .In order to solve this problem ,hepatic functional reserves parameters measurement that resist fluctuation from blood is presented .The method is based on the modified Lambert Beer’s law and realize the correction of ICG concentration measurement in the method of pulse dye spectrophotometry .While the ICG is injected into the patient’s body by the cubital veins ,using the data acquisition unit that developed by project team to collect 805 nm ,940 nm wavelengths of transmission sig‐nals and 730 nm ,805 nm and 890 nm wavelengths of reflected signals in the fingertip skin synchronously ,and then upload 5 sets of data to the computer .Draw the ICG concentration curve according the collected data and blood oxygen saturation before injec‐ting ICG to the human body and then calculate the characteristic parameters ,according to the characteristic parameters calculate the hepatic reserves functional parameters .Taking the measurement of effective hepatic blood flow as an example ,the relative error was obviously decreased when comparing this method and the pulse dye concentration method with the electromagnetic flowmeter (EMF) measurement which is the most accurate method to measure effective hepatic blood flow (EHBF) respectively . The results demonstrate that this method can improve the accuracy of hepatic reserves parameters ,and it can also provide a more accurate detection method of hepatic functional reserves parameters for clinical application .