原发性肝胆管结石病肝切除术风险评估  

Surgical risks for patients with hepatolithiasis undergoing hepatectomy

作　　者：徐勇[1] 任祖海[1] 朱晒红[1] 

机构地区：[1]中南大学湘雅三医院普外科,长沙410013

出　　处：《中南大学学报（医学版）》2012年第9期916-919,共4页Journal of Central South University ：Medical Science

摘　　要：目的:通过术前检测肝胆管结石病患者肝脏功能储备,评估肝切除术的手术风险。方法:回顾性分析134例因原发性肝胆管结石病行肝切除术患者的临床资料,根据术前肝脏储备功能评估方式分为吲哚氰绿组(ICG组)和Child-Pugh评分组(CP组)。比较两组患者术前、术中参数以及术后并发症发生率。结果:ICG组术后肝功能衰竭发生率(0.16%,1/64)明显低于CP组(12.85%,9/70;P<0.05)。ICG组术后总并发症发生率明显低于CP组(18.75%vs37.14%,P<0.05)。结论:吲哚氰绿排泄试验比Child-Pugh评分系统能更有效地评估患者肝储备功能,利于筛选手术患者,减少肝切除术后肝功能衰竭及其他手术并发症,提高手术安全性。Objective： To evaluate the risk of hepatectomy by detecting liver functional reserve preoperatively for patients with primary hepatolithiasis. Methods： The clinical data of 134 patients with primary hepatolithiasis who underwent hepatectomy were reviewed. In terms of evaluation methods for preoperative liver functional reserve they were divided into a Child-Pugh group （group CP） and an indocyanine green group （group ICG）. The preoperative and intraoperative parameters, and the incidence of postoperative complications were analyzed. Results： Liver failure was more common in group CP （12.85%） than that in group ICG （1.56%, P〈0.05）. The overall complication rate in group CP （37.14%） was higher than in group ICG （18.75%, p〈0.05）. Conclusion： ICG15 retention test is more accurate in evaluating liver functional reserve than Child-Pugh scoring system. It may predict the postoperative liver failure in patients with primary hepatolithiasis undergoing hepatectomy, decrease postoperative complications, and increase operation safety.

关 键 词：肝胆管结石病 肝切除术 吲哚氰绿排泄试验 

分 类 号：R657.3[医药卫生—外科学]