肝癌肝部分切除术后患者血小板计数与肝功能恢复的相关性研究  

Postoperative low platelet counts correlate with delayed liver function recovery after partial hepatectomy in patients with hepatocellular carcinoma

作　　者：王科[1] 吴晓峰[1] 范烨[1] 王学浩[1] 

机构地区：[1]南京医科大学第一附属医院肝脏移植中心,南京210029

出　　处：《中华普通外科杂志》2013年第5期371-373,共3页Chinese Journal of General Surgery

摘　　要：目的探讨肝细胞肝癌（下称肝癌）患者行肝部分切除术后血小板计数与肝功能恢复的相关性。方法回顾性分析行肝部分切除术的212例经病理诊断为肝细胞肝癌患者的临床资料，分析患者术后血小板计数与血清丙氨酸转氨酶（alanineaminotransferase，ALT）、天冬氨酸转氨酶（aspart ateaminotransferase，AST）、血清总胆红素（total bilirubin，TB）及凝血酶原时间（prothrombintime，PT）等肝功能指标恢复的关系。结果本组212例肝癌患者中术后低血小板计数（〈100×1^9／L）78例，正常血小板计数（≥100×10^9／L）134例，根据肝功能恢复延迟标准，本组212例肝癌患者中27例出现肝功能恢复延迟，无死亡病例。术后低血小板计数组患者的肝功能指标ALT、AST及TB较血小板计数正常患者峰值高（P〈0．05），而且肝功能恢复延迟；统计学分析显示肝癌肝部分切除术后血小板计数低的患者出现肝功能恢复延迟的几率较血小板计数正常患者明显增高（χ2=9．112，P=0．003）。结论肝癌肝部分切除患者术后低血小板计数（〈100×10^9／L）与肝功能恢复延迟相关，术后低血小板计数可作为肝癌术后肝功能恢复差的预测指标。Objective To investigate the correlation of postoperative platelet counts with liver function recovery after partial hepateetomy in patients with hepatocellular carcinoma. Methods 212 patients with hepatoeellular carcinoma were enrolled in this study. The relation between postoperative platelet counts and serum levels of ALT, AST, TB and PT after operation was analyzed. Results There were 78 patients with a low （ 〈 100×10^9/L） immediate postoperative platelet count in this series of 212 patients who underwent partial liver resection for hepatoeellular carcinoma, and 134 patients with a normal platelet count （ ≥ 100 × 10^9/L）. Based on the criteria, 27 patients were categorized as having delayed postoperative liver function recovery. There was no perioperative mortality in this study. Postoperative peak levels of ALT, AST and TB were significantly higher in patients with low postoperative platelet counts than those with normal platelet counts （ P 〈 0. 05 ）. Statistical analysis showed that low postoperative platelet counts after partial liver resection for hepatocellular carcinoma correlated with increased risk of delayed postoperative recovery （χ2 = 9. 112, P = 0. 003 ）. Conclusions Low postoperative platelet counts were associated with delayed liver function recovery after partial hepateetomy in patients with hepatocellular carcinoma.

关 键 词：癌 肝细胞 肝切除术 血小板计数 

分 类 号：R657.3[医药卫生—外科学]