检测MEGX判定肝储备功能评估手术风险  

MEASURED THE SERUN MEGX FOV EVALUATE THE LIVER FUNCTION RESERVATION AND THE RISK OF OPERATION

作　　者：杨致富[1] 伏敏华[2] 沈国容[2] 王芝香[2] 顾德智[2] 孙增先[2] 许卫东[2] 葛旭明[2] 李锴[2] 

机构地区：[1]北京朝阳医院京西院区,北京100043 [2]江苏省连云港市第一人民医院

出　　处：《肝胆外科杂志》2007年第1期24-26,共3页Journal of Hepatobiliary Surgery

摘　　要：目的通过检测肝癌病人利多卡因代谢产物(MEGX)的量,判定肝储备功能,评估手术风险。方法对准备手术治疗的肝癌病人术前静注利多卡因1mg/kg体重,15min后抽血,用HPLC法检测MEGX,与常用肝生化检查、Child-Pugh分级方法比较。结果根据MEGX检测结果将55例准备手术的肝癌病人分成手术耐受组和手术非耐受组。耐受组均经受了手术打击,无术后严重肝衰发生,而非耐受组有两例手术治疗,术后均出现了严重的肝衰,其中一例死亡。结论MEGX试验较Child-Pubh分级方法更能准确判定肝储备功能,对评估手术风险有较高的特异性。Objective We measured the serun MEGX concentration 15 minute after injectiong lidocaine of patients with liver cancer, to study the liver function reservation, and evaluate the risk ofoperation, Methods The patient was injected of lidocatine 1 mg/ kg previous to operation and the blood samples were collected for analysis of MEGX at 15 minute, MEGX was determined by HPLC method,and campared with general biochemistry test for liver and Ghild-Pugh＇s sclassification, Results We divided the 55 patients with liver cancer into two groups by serum MEGX concentration ： toleratior proup of operation, non-tolerator group. The tolerator group could endure the strike of operation and have not happen serious hypohepatia, but we opeated on two patients in non-tolerator group, they could not endure the strikd and one patient died. Conclusions We concluded that measurement of serum MEGX concentration 15 minute after lidocaine could be a reliable quantitative liver functiong reservation test, and it excelled general biochemistry test for liver and Child-Pugh＇s classification. It has higher specificity that evaluated the risk of operation.

关 键 词：肝癌 MEGX 肝储备功能 手术风险 

分 类 号：R575[医药卫生—消化系统]