吲哚氰绿清除试验对丙肝肝硬化脾切除术后门静脉血栓形成风险的预测价值  

Value of indocyanine green clearance test for predicting the risk of portal vein thrombosis after splenectomy in patients with hepatitis C cirrhosis

作　　者：邱越[1] 熊杰[1] 彭英[1] 刘宁[1] 晏华军[1] 沈雄山[1] 

机构地区：[1]湖北省孝感市中心医院普通外科,湖北孝感432000

出　　处：《中国普通外科杂志》2014年第1期87-90,共4页China Journal of General Surgery

基　　金：2013-2014年度湖北省卫生厅科研指导性项目(JX6c-55)

摘　　要：目的:探讨吲哚氰绿(ICG)清除试验对丙肝肝硬化脾切除术后门静脉血栓形成风险的预测价值。方法:回顾性分析2011年1月—2012年12月115例丙肝肝硬化行单纯性脾切除患者的临床资料,分析术前ICG清除试验结果与术后PVT形成风险的关系。结果:115例患者术后发生PVT 41例(35.65%,41/115)。PVT发生率在ICG 15 min滞留率(ICGR15)≤10%时为20.51%,10%<ICGR15≤20%时为34.04%,ICGR15>20%时为58.62%,差异有统计学意义(P<0.05)。发生PVT患者ICGR15平均值为(26±14)%,ICG血浆清除率(KICG)平均值为(0.098±0.026)/min;未发生PVT患者的ICGR15平均值为(14±11)%,KICG平均值为(0.166±0.067)/min,差异有统计学意义(P<0.05)。结论:ICG清除试验能可评估丙肝肝硬化患者脾切除术后PVT发生风险的预测指标。Objective： To investigate the value ofindocyanine green （ICG） clearance test in predicting the risk of portal vein thrombosis （PVT） after splenectomy in patients with liver cirrhosis from hepatitis C. Methods： The clinical data of 115 patients with liver cirrhosis due to hepatitis C undergoing splenectomy between January 2011 and December 2012 were reviewed. The relationship between the results of preoperative ICG clearance test and postoperative risk of PVT was analyzed. Results： Forty-one （35.65%） of the 115 patients developed PVT after surgery, qhe incidence of PVT was 20.51% in patients with ICG retention at 15 minutes （ICGR15） ≤10%, was 34.04% in cases with 10%〈ICGR15≤20%,and was 58.62% in those with ICGR15〉20%, and the difference among them had statistical significance （P〈0.05）. The average ICGR15 and elimination rate constant （KICG） in patients who developed PVT was （26±14）% and （0.098±0.026）/min, while in those without PVT was （14±11）% and （0.166±0.067）/min respectively, and both differences had statistical significance （both P〈0.05）. Conclusion： ICG clearance test can be used as an indicator for predicting the risk of PVT after splenectomy in patients with cirrhosis from hepatitis C.

关 键 词：肝硬化 脾切除术 静脉血栓形成 肝炎 丙型 

分 类 号：R675.3[医药卫生—外科学]