血小板计数对肝癌肝部分切除术患者术后肝功能恢复的影响

Study on the influence of platelet count on recovery of liver function in patients with hepatocellular carcinoma after partial hepatectomy

目的探讨血小板计数对肝癌肝部分切除术患者术后肝功能恢复的影响。方法回顾性分析2010年6月至2014年6月206例行肝部分切除术的原发性肝癌患者的临床资料,其中术前血小板计数（PLT）〈100×10~9/L者75例作为观察组,PLT≥100×10~9/L者131例作为对照组对比两组患者术后血清丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、血清总胆红素（TB）及凝血酶原时间（PT）等肝功能指标的变化情况,分析患者术后PLT计数与肝功能指标恢复的关系。结果两组术前的血清ALT、AST、TB、PT水平比较差异无统计学意义（P〉0.05）;两组术后血清ALT、AST、TB、PT水平持续升高,第3天达到峰值后逐渐下降对照组术后10 d恢复至术前水平,观察组术后14 d恢复至术前水平;观察组术后1-10 d血清ALT、AST、TB、PT水平明显高于对照组,差异具有统计学意义（P〈0.05）;观察组肝功能恢复延迟率明显高于对照组（25.3%比5.3%）差异具有统计学意义（P〈0.05）。结论肝癌肝部分切除术后肝功能恢复与血小板计数与密切相关,术前低血小板计数可以作为肝癌肝部分切除术肝功能恢复延迟的预测指标。

Objective To explore the influence of platelet count on the recovery of liver function in patients with hepatocellular carcinoma after partial hepatectomy.Methods The clinical data of 206 cases of hepatocellular carcinoma received partial hepatectomy in this hospital during June 2010 to June 2014 were retrospectively analyzed,75 of them with preoperative platelet count（PLT） 100 × 10~9 /L were allocated in observation group,and 75 of them with PLT count at 100 × 10~9 /L or over were listed in control group,and the postoperative serum liver function indexes as alanine transaminase（ALT）,aspertate aminotransferase（AST）,total bilirubin（TB） and prothrombin time（PT） were compared between patients in these two groups,and the influence of platelet count on recovery of liver function after partial hepatectomy in patients with hepatocellular carcinoma had been studied.Results The difference in preoperative serum levels of ALT,AST and TB and PT between these two groups was not statistically significant（P〉0. 05）.The postoperative serum levels of ALT,AST,TB and PT in these two groups were continued to be raised,and the peak was gradually declined on the third day,and it in control group was recovered to the preoperative level after 10 d,and it in observation group recovered to preoperative level after 14 d.The serum levels of ALT,AST,TB and PT in observation group were significantly higher than those of control group in 1 ~10 days after operation,and the difference was statistically significant（P〈0. 05）.The rates of delayed recovery of liver function in observation group and control group were 25.3%（19/75） vs.5.3%（7/131） respectively,the rate of recovery of liver function in observation group was significantly higher than that of control group,and the difference was statistically significant（P〈0. 05）.Conclusion The recovery of liver function in patients with hepatocellular carcinoma after partial hepatectomy was closely correlated to the platelet count,the preoperative low platelet count can be used as a predictor for delayed recovery of liver function after partial hepatectomy in patients with hepatocellular carcinoma.