肝脏切除手术风险预测模型研究

A study of the risk prediction for post-liver resection hepatic insufficiency

目的建立肝脏切除术前风险预测模型。方法回顾性分析2012年6月至2013年9月我科连续性完成52例半肝切除的临床资料,采用Logistic回归分析模型明确术后肝功能不全发生的预测因素。结果术前吲哚菁绿15分钟滞留率(ICG R15)、残余肝脏体积/标准肝脏体积(RLV/SLV)、脾脏体积增大倍数(△SV/SSV)均为半肝切除术后肝功能不全发生的独立危险因素(P=0.001,P=0.003和P=0.002),风险系数R=3.545×(ICG R15)-5.743×(RLV/SLV)+8.982×(△SV/SSV)。结论相对较高的ICG15R和△SV/SSV,以及较低的RLV/SLV可能影响肝脏切除术后患者肝功能不全的发生。

Objective To establish a risk prediction model for the liver resection. Method We retrospectively analyzed the clinical data of 52 cases who were completed hemihepatectomy consecutively in our department from Jane 2012 to Sep 2013. The pre- diction factors for Postoperative liver dysfunction were cleared by Logistic regression analysis model. Results Indocyanine 15-minute Retention （ ICG15 R） , the ratio of residual liver volume to the standard liver volume （ RLV/SLV ） and the spleen volume increases in mul- tiples （ A SV/SSV） are all independent risk factors for liver insufficient after hemihepatectomy （ P = 0. 001, P = 0. 003 and P = 0. 002, respectively）. The risk coefficient （R） =3. 545 × （ICG 15R）-5. 743 × （RLV/SLV） ＋ 8. 982×（ASV/SSV）. Conclusions Rela- tively high ICG R15 and ASV/SSV, and low RLV/SLV may affect in patients with liver dysfunction occurs after liver resection.