吲哚菁绿排泄试验评估肝脏缺血再灌注损伤的临床研究

A clinical research of indocyanine green clearance test in evaluating hepatic ischemia-reperfusion injury

回顾性分析46例采用吲哚菁绿排泄试验(ICG)对术中肝脏缺血再灌注损伤(HIRI)的评估价值。术中阻断第一肝门23例(阻断组),未阻断第一肝门23例(未阻断组)。术前及术中各检测1次ICG,计算术中与术前吲哚菁绿15min滞留率的差值(ΔR15),记录术前及术后肝功能及术后并发症。结果显示未阻断组ΔR15显著低于阻断组(P<0.01),两组术后同时间点谷丙转氨酶(ALT)、谷草转氨酶(AST)含量比较差异有统计学意义(P<0.05)。ICG作为评估肝脏储备功能的有效方法,采用术中与术前ΔR15能有效的评估HIRI。

To analyze the effect of indocyanine chemia-reperfusion injury（HIRI） retrospectively. patients were treated without Pringle maneuver （ green clearance test（ICG） on 46 cases of intraoperative hepatic is- 23 patients underwent with Pringle maneuver （PM group） and 23 non-PM group）. All patients underwent ICG preoperatively and intraoperatively to calculate the change of preoperative and intraoperative indocyanine green clearance test （△R15）. The liver function was recorded on days 1, 3, and 5 after the surgery and the complications. The result displayed that △R15 in non-PM group was significantly lower than those in the PM group （P 〈 0. 01 ）, and there was signifi- cant difference between the two groups in ALT, AST at the same time point after surgery （P 〈 0. 05 ）. ICG as an effective method in evaluating hepatic reserve function,with use of △R15, can evaluate HIRI very well.