摘要
目的 介绍一种进行ICG清除试验检测肝储备功能的新方法-脉动色素浓度测定法(PDD法),评价其可行性和实用性。方法 PDD法进行ICG清除试验检测44例原发性肝癌患者ICG 15分钟滞留率(R15)、血浆清除率(K值)及有效肝脏血流量(EHBF),分析这些指标与肝硬化以及Child-Pugh分级之间的关系。结果 PDD法能在6~8分钟内完成ICG清除试验检测。37例患者肝癌合并有不同程度的肝硬化,合并肝硬化组与未合并肝硬化组相比EHBF下降,但无统计学意义(P〉0.05),K值明显下降,R15明显升高,差别具有统计学意义(P〈0.05);随着Child-Pugh分级的递增,EHBF、K值下降、R15升高在A、B、C级间均有显著性差异(P〈0.05)。36例患者行手术治疗未出现严重术后并发症,术后恢复良好。结论 PDD法是行ICG清除试验检测肝储备功能实用可行的理想方法;R15、K值、EHBF能很好的反映原发性肝癌患者的肝储备功能;K值、R15可能是更为敏感的指标。
Objective To introduce a new method of indoeyanine green clearance test for measuring hepatic reserve function and evaluate its feasibility and practicability. Methods 44 patients with primary liver cancer were enrolled in this study. The ICG clearance test was done by PDD. The cover of ICG 15 minutes retention rate( R15 ) ,clearance rate(K) and effective hepatic blood flow (EHBF) were measured to evaluate correlationship with liver cirrhosis and Child-Pugh classification. Results The measurements could be accomplished within 6 - 8 minutes. 37 patients were confirmed liver cirrhosis of different degree. EHBF in the cirrhosis group were lower than those in the no-cirrhosis, but there were no significant differences. However, The K value in the cirrhosis group was significantly lower than those in the no-cirrhosis group( P 〈 0. 05 )and R15 was obviously higher( P 〈 0. 05 ). Along with the increasing of the Child-Pugh classification, the K value and EHBF were decreased significantly and R15 was increased remarkably among Child-Pugh A ,B and C(P 〈0. 05 ). 36 patients underment operation without serious complications. All of the patients recovered very well after the operation. Conclusions PDD is a practicable ideal method of indoeyanine green clearance test for measuring hepatic reserve function; R15 ,K value and EHBF can be used to evaluate the hepatic reserve function in patients with primary liver cancer. K value and R15 are probably more sensitive than EHBF.
出处
《肝胆外科杂志》
2006年第3期189-191,共3页
Journal of Hepatobiliary Surgery