肝脏体积变化与病肝储备功能的关系研究  

A study on the correlation between hepatic volume and liver functional reserve

作　　者：黎一鸣[1] 吕凡[1] 吉鸿[1] 白芝兰[2] 雷团结[1] 

机构地区：[1]西安交通大学第二医院普外科,西安710004 [2]西安交通大学第二医院CT室,西安710004

出　　处：《中华普通外科杂志》2003年第2期79-81,共3页Chinese Journal of General Surgery

摘　　要：目的建立国人正常肝脏体积计算公式 ,探讨肝脏体积变化在评价病肝储备功能方面的临床意义。方法本研究采用螺旋CT对 2 80名正常人、85例肝硬化患者进行了腹部扫描并求出其肝脏体积。使用直线相关和回归的方法研究正常人群肝脏体积与体表面积的关系 ,得出相应的回归方程。求出肝硬化患者肝脏体积的变化率 ,分析其与Child肝功能分级和术后并发症之间的相互关系。结果正常成年人肝脏的平均体积为 (12 5 0± 141)cm3,其与体表面积呈正相关关系 ,相关系数为 0 96 ,回归方程为LV(cm3) =6 13×BSA(m2 ) +16 2 8。对于肝硬化患者 ,在ChildA级肝脏平均体积为 (10 92± 2 76 )cm3,ChildB级为 (86 8± 16 3)cm3,ChildC级为 (6 5 2± 76 )cm3,三者之间差异均存在着显著意义 (P <0 0 0 1)。ChildB级和ChildC级与正常组比较 ,肝脏平均体积明显减小 (P <0 0 0 1)。当病肝体积缩小 40 %以上时 ,术后并发症发生率明显增高。肝脏体积变化率与Child肝功能分级间存在着交错现象。结论　CT测量方法结合成人正常肝脏体积公式运算 ,能定量评价病肝体积变化 ,从而有助于客观评价病肝储备功能状况。Objective To establish standard liver volume formula of healthy Chinese and to explore if there is a correlation between changes of hepatic volume and hepatic functional reserve.Methods Two hundred and eighty healthy volunteers and 85 cirrhotics undergone serial abdominal H-CT scanning. The relation between normal liver volume measured by CT and body surface area(BSA) was studied by linear regression and correlation method, the standard liver volume formula was deduced. For cirrhotic patients, the change rate of liver volume was calculated and was compared with their Child class and postoperative complications.Results The mean normal hepatic volume for Chinese adults was (1?250±141)?cm 3. There is a positive correlation between estimated liver volume in vivo and body surface area[r=0.96, LV(cm 3)=613×BSA(cm 3)+162.8]. The mean liver volume (SD) for Child class A cirrhotics was (1?092±276)?cm 3, (868±163)?cm 3 for class B, and (652±76)?cm 3 for class C. Differences were observed among the three classes (P<0.001) and between classes B, C and control group (P<0.001). When hepatic volume of the cirrhotics decrease by more than 40%, postoperative complications increase significantly, though the liver volume change rate was not in absolutely good accordance with Child class. Conclusion The volume changes of cirrhotic liver can be obtained by CT scan and the standard liver volume formula, which is helpful for better understanding patient′s liver functional reserve.

关 键 词：肝硬化 体积描记术 肝功能试验 

分 类 号：R657.3[医药卫生—外科学]