肝癌肝部分切除术后患者血小板计数与肝功能恢复的相关性研究

The correlation study of postoperative platelet count with liver function recovery after partial hepatectomy in patients with hepatocellular carcinoma

目的探讨肝细胞肝癌(下称肝癌)行肝部分切除术后患者血小板计数与肝功能恢复的相关性。方法回顾性分析2005年2月至2011年2月在我院行肝部分切除术的212例经病理诊断为肝细胞性肝癌患者的临床资料,分析术后血小板计数与血清谷丙转氨酶(ALT),血清谷草转氨酶(AST),血清总胆红素(TB)及凝血酶原时间(PT)等肝功能指标恢复的关系。结果 212例肝癌患者中,低血小板计数(<100×109/L)为78例,正常血小板计数(≥100×109/L)为134例,出现肝功能恢复延迟的为27例。Kaplan-meier分析显示,肝癌肝部分切除术后,血小板计数低的患者出现肝功能恢复延迟的几率显著升高,为血小板计数正常患者的3.6倍。结论术后患者低血小板计数(<100×109/L)可导致肝功能恢复延迟,术后低血小板计数可作为肝癌术后肝功能恢复差的指标,提高肝癌术后血小板计数是防治肝功能衰竭的可行策略。

Objective To investigate the correlation of postoperative platelet counts with the liver function recovery after partial hepatectomy in patients with hepatocellular carcinoma（HCC）.Methods Prospectively collection of clinical data of the 212 patients who received partial liver resection in our hospital from February 2005 to February 2011 and the diagnosis of hepatocellular carcinoma was confirmed by pathology after operation.Retrospectively analysis of the relationship between postoperative platelet counts and serum levels of alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,total bilirubin（TB） and prothrombintime（PT） after operation.Results In the 212 cases of HCC patients,postoperative platelet count in 78 cases were low（100×109/L）,the other 134 cases were normal（≥100×109/L）,and 27 cases showed delayed recovery of liver function.Kaplan-Meier analysis showed that the patients with low postoperative platelet counts had 3.6 times risk of delayed recovery of liver function than that the normal ones after partial hepatectomy.Conclusion Low postoperative platelet counts is associated with delayed liver function recovery after partial hepatectomy in patients with hepatocellular carcinoma,suggesting that platelet count is a risk factor of delayed postoperative recovery of liver function.