原发性肝癌患者介入化疗栓塞前肝储备功能测定的临床价值

The determination of liver reserve function before chemoembolization in patients with primary hepatocellular carcinoma:its clinical significance

目的探讨用吲哚氰绿潴留率(ICGR15)评估原发性肝癌(HCC)患者介入化疗栓塞前肝储备功能的临床价值。方法43例HCC患者介入化疗栓塞前测定ICGR15,并根据结果将患者分为3组,同时对所有患者进行Child-Pugh评分。根据介入化疗栓塞后肝脏功能损伤程度及恢复情况将患者分为肝功能轻度损伤组(M组)和肝功能重度损伤组(S组)。分析介入化疗栓塞后3组间ICGR15改变的差异。结果介入化疗栓塞后3组间ICGR15变化差异具有统计学意义(P<0.05),介入化疗栓塞前不同的Child-Pugh分级间ICGR15变化差异有统计学意义(P<0.05)。结论与Child-Pugh分级相比,ICGR15能更准确地评估介入化疗栓塞前肝储备功能。

Objective To evaluate the clinical usefulness of detel^aining the liver reserve function by estimating the retention rate of indocyanine green at fifteen minutes （ICGR15） before interventional chemoembolization in treating patients with primary hepatocellular carcinoma （HCC）. Methods Forty-three patients with HCC were enrolled in this study. Before interventional chemoembolization ICGR15 and Child- Pugh classification were estimated in all patients. Based on the 1CGR15, the patients were divided into three groups. After chemoembolization, all the patients were divided into two groups according to liver function condition： group M （showing mild hepatic dysfunction） and group S （developing severe hepatic dysfunction）. The occurrence of postoperative hepatic dysfunction and the difference in the hepatic function changes between three groups were analyzed. Results After interventional chemoembolization the occurrence of hepatic dysfunction were significantly different between three groups divided by ICGR15 test （P 〈 0.05）. And significantly different in hepatic reserve function existed between the two groups divided by Child-Pugh classification （P 〈 0.05）. Conclusion The hepatic reserve function in HCC patients can be more precisely evaluated by ICGR15 than by Child-Pugh classification. （J Intervent Radiol, 2009, 18： 757-759）