肝脏功能评估在临床中的应用与发展  

Liver function assessment:Application and improvement in clinical practice

作　　者：杜顺达 车璐 毛一雷 

机构地区：[1]中国医学科学院、北京协和医院肝脏外科,北京市100730

出　　处：《世界华人消化杂志》2012年第27期2549-2553,共5页World Chinese Journal of Digestology

基　　金：国家自然科学基金资助项目;No.30901453~~

摘　　要：术前肝功能评估对制定手术方案、判断预后非常重要.由各指标组成的综合评分系统,考虑了肝脏合成、分泌等功能及相关脏器的影响.各种代谢性肝功能定量评估试验反映肝脏功能的能力不一,与综合评分系统共同应用,能更好的评估肝功能和预后.但这些评估只是针对肝脏整体.肝脏体积计算可以获得各部分的体积,但在肝硬化肝功能受损时体积并不能准确的反映功能.去唾液酸糖蛋白受体显像技术可以三维反映肝脏功能,结合计算机技术,进行术前模拟切除,可以获得手术风险信息,判断预后,目前被认为是一个有前途的肝功能评估方法.Preoperative liver function assessment is very important for surgical planning and prognosis.A comprehensive scoring system incorporates various parameters which reflect a certain aspect of liver function such as synthesis and secretion,as well as impact of related organs.Currently,various metabolic liver function tests differ in their ability to reflect liver function.Combination of the scoring system with metabolic tests can better assess liver function and prognosis.However,these assessments only account for overall liver function.Liver volume assessment allows obtaining every segment volume without function,especially in case of cirrhosis.Imaging technique based on asialoglycoprotein receptor（ASGPR） reflects liver function in three dimensions and is now considered a promising liverfunction assessment.When combined with computer technology,it allows surgeons to perform resection simulation and evaluate surgical risk and prognosis preoperatively.

关 键 词：肝功能评估 肝切除 预后 去唾液酸糖蛋白受体 

分 类 号：R657.3[医药卫生—外科学]