联合应用吲哚氰绿15分钟储留率与保留肝容积率评估肝脏储备功能的研究

The value of combing using ICGR15 and reservation liver volume rate to assess the hepatic function reserve

目的联合应用吲哚氰绿15 min储留率（ICGR15）及保留肝容积率（RLVR）评估原发性肝癌患者术前肝脏储备功能。方法回顾性分析2010年1月-2011年1月在中国医科大学附属第一医院行肝脏部分切除术的原发性肝癌患者,术前均进行Child-Pugh评分,应用脉动色素浓度（PDD）法检测ICGR15,应用CT测量保留肝容积率（保留肝容积率=保留肝容积/预计肝容积×100%,预计肝容积=121.75＋16.49×体重）。根据ICGR15水平将患者分为A（〈10%）、B（10%-20%）、C（〉20%）三组,依据术后肝功能恢复情况将患者分为肝功能恢复良好组（G组）、肝功能代偿轻度不全组（M组）、肝功能代偿重度不全组（S组）。分析术后各肝功能恢复组的ICGR15、Child-Pugh评分之间的关系,不同ICGR15水平组内术后不同肝功恢复情况组的RLVR之间关系。结果不同肝功恢复情况组的ICGR15之间有差异（P〈0.05）,Child-Pugh评分之间无差异（P〉0.05）,A（〈10%）、B（10%～20%）两组组内术后不同肝功恢复情况组的RLVR之间存在差异（P〈0.05）。结论联合应用ICGR15及RLVR对肝储备功能有很好的预测价值并可以指导确定治疗方案。

【Objective】To study the value of combing using ICGR15 and reservation liver volume rate（RLVR） to evaluate the hepatic function reserve in patients with primary hepatic cancer（PHC）.【Methods】82 patients with PHC under hepatic resection were studied in our hospital from 2010 January to 2011 January Child-Pugh evaluation,ICGR15,RLVR {the ratio of reservation liver volume to estimated liver volume,the estimated liver volume =121.75 ＋16.49 ×body weight（kg）} measurement were performed in all patients.3 groups were divided according to liver function recovery after operation： good recovery group（group G）,mild liver dysfunction group（group M）,and severe liver dysfunction group（group S）.Another 3 groups were divided according to the ICGR15 level： ICGR1510%（group A）,ICGR15 10%～20%（group B）,ICGR1520%（group C）.To analyze the relationship between ICGR15,Child-Pugh score in different liver function recovery groups,liver dysfunction rate between different ICGR15 level and RLVR between different liver function recovery groups in the same ICGR15 level.【Results】ICGR15 in group M obviously increased than that in group G（P〈0.05）.Child-Pugh score had no differences（P〈0.05）.There was no patient in Group C.RLVR had differences in each group B and group C（P〉0.05）.【Conclusion】 Combination of using ICGR15 and RLVR has higher predictive value in hepatic function reserve,can also indicate surgery project.