术前总胆红素水平与肝切除术后患者肝功能恢复的相关性

Correlation between preoperative serum bilirubin level and liver function recovery in patients after hepatectomy

[目的]分析术前总胆红素(TBIL)水平与肝切除术后患者肝功能恢复的相关性。[方法]选取原发性肝癌患者93例为研究对象,检测患者术前及术后第2天、第5天、第10天血清TBIL,天冬氨酸氨基转移酶(AST)及丙氨酸氨基转移酶(ALT)水平。分析术前血清TBIL水平与肝切除术后患者肝功能恢复的相关性。[结果]术后第2天,患者TBIL、AST、ALT水平较术前增高,后各时点均呈下降趋势(P<0.05);经相关性分析结果显示,血清TBIL水平与AST、ALT水平均呈正相关(P<0.05)。93例患者术后肝功能恢复良好50例;其术前血清TBIL水平低于肝功能恢复差者(P<0.05);回归分析结果显示,术前血清TBIL水平升高可能是肝切除术患者术后肝功能恢复差的影响因素(95%CI:1.068~1.174;P<0.05);结果显示,术前血清TBIL水平预测术后肝功能恢复情况的AUC>0.8,当达到最佳阈值时,可获得最佳预测价值。[结论]肝切除术前血清TBIL升高患者可能提示术后肝功能恢复差高风险。

[Objective]To analyze the correlation between preoperative bilirubin(TBIL)levels and the recovery of liver function in patients after hepatectomy.[Methods]Ninety-three patients with primary liver cancer who admitted in our hospital from March 2018 to October 2019 were selected as the research subjects.The levels of serum TBIL,aspartate aminotransferase(AST)and alanine aminotransferase(ALT)before the operation and in the day 2,day 5 and day10 after the operation were detected.The correlation between the preoperative serum TBIL level and the recovery of liver function after hepatectomy was analyzed.[Results]In the day 2 post-op,the levels of TBIL,AST and ALT were increased and higher than those before operation,and showed a downward trend at every time point afterwards(P<0.05);the results of correlation analysis showed that serum TBIL levels were positively correlated with AST and ALT levels(r>0,P<0.05);among the 93 patients with hepatocellular carcinoma.In the 50 cases with liver function well recovered after operation,the preoperative serum TBIL level was lower than those with poor liver function recovery(P<0.05).Regression analysis showed that increased serum TBIL level before operation might be the influencing factor for poor liver function recovery in patients with hepatectomy(95%CI:1.068-1.174,P<0.05).The results showed that the AUC of preoperative serum TBIL level in predicting the postoperative recovery of liver function was>0.8,and when the optimal threshold was reached,the best predictive value could be obtained.[Conclusion]Patients with elevated serum TBIL before hepatectomy may be at high risk for poor postoperative liver function recovery.