失代偿期肝硬化肝脏储备功能及预后的评估

Evaluate the prognosis and liver functional reserve of patients with decompensated liver cirrhosis

目的评估肝硬化失代偿期患者的肝脏储备功能及短期(3个月)预后。方法应用MELD评分、CTP分级及肝硬化的CT分级分别对81例肝硬化失代偿期患者进行评分及分级,比较不同MELD评分组、CTP分级组及CT分级组患者3个月的病死率及不同评价系统之间的相关性。结果33例患者在3个月内死亡。随着MELD、△MELD评分、CTP分级及CT分级的增加,患者的病死率逐渐升高,死亡组与出院组比较有统计学意义(P<0.05)。MELD评分结果与CT分级结果的比较具有一致性,存在着对应关系。肝硬化CT分级与肝功能CTP分级的严重程度存在着对应关系,组间比较存在统计学差异(P<0.05)。结论MELD模型与CTP分级和CT分级均能较好的评价失代偿期肝硬化患者的肝脏储备功能及短期预后。

Objective Application of the model for end-stage liver disease （MELD） and Child-Turcotte-Pugh （CTP） System and helical CT to evaluate the prognosis and liver functional reserve of patients with decompensated liver cirrhosis. Methods Eighty one patients with decompensated liver cirrhosis were graded with MELD, CTP and CT for- mula. The death rate was observed within three month. Results Thirty three patients died within three month. When MELD, CTP and CT formula were increasing, the mortality of patients was also increasing. The result of MELD grade was consistency with CT classification. The result of CT classification was relativity with CTP grade. Conclusion Both MELD and CTP scores can accurately predict the short term prognosis of patients with decompensated liver cirrhosis. CT grading of liver cirrhosis plays an important role in the assessment of the severity and prognosis of liver cirrhosis.