间接胆红素在肝切除术安全评估中的临床价值

Assessment of safety in hepatic resection focusing on indirect hyperbilirubinemia

目的探讨间接胆红素在肝切除术安全评估方面的临床价值。方法回顾性分析2003年1月—2013年12月73例行肝切除术的肝硬化合并肝细胞癌患者的临床资料,将正常胆红素组(22例)与总胆红素>19μmol/L,直接胆红素<8.5μmol/L的高胆红素组(51例)临床指标进行对比分析,对两组肝切除术后的肝衰竭发生率进行比较。结果两组患者术前凝血酶原时间,术前白蛋白水平,手术时间,术中出血量差异均无显著性意义(P>0.05),两组患者肝功能衰竭发生率差异亦无显著性意义(P>0.05)。结论高总胆红素低直接胆红素患者与正常胆红素患者具备同样的肝切除手术安全性。

Objective To investigate the clinical value of indirect bilirubin in the safety assessment of liver resection. Methods Through retrospective analysis 73 patients of hepatocellular carcinoma with cirrhosis underwent hepatic resection in our hospital from January 2003 to December 2013, the clinical indicators of total bilirubin of normal level （22 cases） and total bilirubin more than 19 μmol/L direct bilirubin less than 8.5 μmol/L in patients （51 cases） were analyzed, he-patic failure incidence of the two groups after hepatectomy were analyzed.Results The prothrombin time, serum albumin, operation time, intraoperative bleeding were similar in the two groups （P〉0.05）.There were no significant differences in hepatic failure incidence of the two groups（P〉0.05）.Conclusion High total bilirubin and low direct bilirubin in patients have the same security of hepatic resection with normal bilirubin in patients.