吲哚氰绿排泄试验估价肝储备功能及在联合术式选择中的作用

Estimation of hepatic functional reserve with indocyanine green excretive test and its effect in the selective indication of combined splenorenal shunt and devascularization

目的 了解吲哚氰绿排泄试验评估肝储备功能及在分流加断流术 (联合术 )适应证的选择 ,确定手术时机中的应用价值。方法 通过吲哚氰绿排泄试验与常规方法比较 ,结合临床资料及术后并发症分析 ,确定这一方法在评估肝储备功能中的作用。结果 当血浆吲哚氰绿 1 5min潴留率 (ICGR1 5)小于 2 0 % ,可实施联合术 ;而当ICGR1 5大于 2 5% ,特别是病肝明显缩小者 ,不宜施行联合术。结论 吲哚氰绿排泄试验能够更为客观的反映病肝储备功能 ,对外科术式的选择。

Objective To study the evaluation on hepatic functional reserve with indocyanine green(ICG)excretive test and its applied valuation on selecting indication and deciding operative time of combined splenorenal shunt and devascularization. Methods The effect of ICG excretive test in the evaluation on hepatic functional reserve was decided by comparing with the routine methoes and analysing the clinical information and the postoperative complications.Results The combined splenorenal shunt and devascularization could be selected on the patients with portal hypertension when the ICGR 15 was less than 20%.On the contrary,this kind of operation should not be used when ICGR 15 was more than 25%,especially one with obvious atrophy of liver.Conclusion The ICG excretive test can more objectively reflect the hepatic functional reserve and plays a positive role in selecting indication and deciding operative time of combined splenorenal shunt and devascularization.