吲哚氰绿排泄试验评价肝储备功能与拔管时间的研究

Evaluation of liver functional reserve and extubation time by indocyanine green excretion test

目的:术前评估肝硬化患者肝脏储备功能,及其与患者拔管时间及改良OAA/S评分的关系。方法:对60例肝硬化失代偿患者术前行吲哚氰绿排泄试验。将患者分为三组:按吲哚氰绿15min储留率(ICGR15)将患者分为两组I1组,I2组,另30例肝功能正常患者为对照组(C组)。观测ICGR15与患者拔管时间及改良OAA/S评分的关系。结果:拔管时间I1组与I2组均明显长于C组(P<0.05或P<0.01);发生呕吐,烦躁者I1组与I2组均明显多于C组(P<0.05或P<0.01),OAA/S评分>3分者I1组与I2组均多于C组,但无统计学意义。结论:ICGR15对于判断肝硬化患者围术期拔管的时间具有一定的参考价值。

Objective：To evaluate the liver reserve function in patients with cirrhosis and its relation to extubation time in patients and modified OAA/S score.Methods：Sixty patients with decompensatively stative hepatic cir-rhosis scheduled to received devascularization in combination with splenectomy,the ICG excretion test were performed one day before operation.The patients were divided into three groups：group I1（n=30,20〈ICGR15 25）（ICGR15：indocyanine green retention at fif-teen minutes）;group I2（n=30,ICGR15〉 25）;groupC（n=30,control group）.ICGR15 and extubation time were observed and improve-ment in OAA/S score.Result：I1 group and I2 group extubation time were significantly longer than group C（P〈0.05 or P〈0.01）;vomit-ing,irritability are I1 group and I2 group were significantly more than C group（P〈0.05 or P〈0.01）;OAA/S score〉3 were I1 and I2 groups were more than group C,but not statistically significant.Conclusion：ICGR15 may play a role estimate extubation time of the pa-tient with hepatic cirrhosis.