中国现代普通外科进展2024,Vol.27Issue(5) :373-376.DOI:10.3969/j.issn.1009-9905.2024.05.008

肝有效血容量对肝癌术后肝功能不全的预测价值

Predictive value of effective hepatic blood flow in postopera-tive liver insufficiency in patients with hepatocellular carci-noma

陈森 刘艳国 张永明 杨松竹
中国现代普通外科进展2024,Vol.27Issue(5) :373-376.DOI:10.3969/j.issn.1009-9905.2024.05.008

肝有效血容量对肝癌术后肝功能不全的预测价值

Predictive value of effective hepatic blood flow in postopera-tive liver insufficiency in patients with hepatocellular carci-noma

陈森 1刘艳国 1张永明 1杨松竹1
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作者信息

  • 1. 烟台市烟台山医院 肝胆外科(山东 烟台 264000)
  • 折叠

摘要

目的:探讨肝有效血容量(EHBF)预测肝癌术后肝功能不全发生的价值.方法:回顾123例肝细胞癌手术患者的临床资料,测得EHBF和吲哚菁绿15 min滞留率(ICG R15),并行Child-Pugh评分,观察患者术后肝功能恢复情况.比较不同肝功恢复组中ICG R15、EHBF差异及ICG R15、EHBF不同分组中术后肝功能不全的发生率.通过受试者工作特征(ROC)曲线比较ICG R15、EHBF诊断价值.结果:123例患者中共有41例(33.3%)术后发生肝功能不全.肝功能良好组ICG R15平均值为(8.95±7.18)%,EHBF 平均值为(1.01±0.37)L/min;肝功能不全组 ICG R15 平均值为(15.88±11.55)%,EHBF平均值为(0.75±0.28)L/min.两组差异均有统计学意义(P<0.05).EHBF≥1.0 L/min组术后肝功能不全发生率13.0%,<1.0 L/min术后肝功能不全发生率45.5%,差异有统计学意义(P<0.05).ICG R15 ROC 曲线下面积 0.710(95%CI:0.616~0.804),临界值为 7.6,敏感度 78.0%,特异度59.8%.EHBF ROC曲线下面积0.718(95%CI:0.624~0.813),临界值为 0.35,敏感度73.2%,特异度70.7%.结论:EHBF可有效预测肝癌术后肝功能不全的发生,且可能与ICGR15具有相似检验效能.

Abstract

Objective:To investigate the value of effective hepatic blood flow in predicting the occurrence of liver insufficiency after operation of hepatocellular carcinoma(HCC).Methods:The 15-minute clearance of Indocyanine Green(ICGR15)and EHBFwere measured in 123 patients with hepatocellular carcinoma(HCC)after hepatectomy.To compare the difference of ICGR15 and EHBF in different groups of liver function recovery and the incidence of postoperative liver function insufficiency in different groups of ICG R15 and EHBF.The diagnostic value of ICG R15 and EHBF was compared by receiver operating characteristic(ROC)curve.Results:Of the 123 patients,41(33.3%)developed liver insufficiency after operation.The average values of ICG R15 and EHBF in patients with good liver function were(8.95±7.18)%and(1.01±0.37)min,respectively,while those in patients with liver insufficiency were(15.88±11.55)%and(0.75±0.28)min,respec-tively.The difference was statistically significant(P<0.05).The incidence of postoperative liver in-sufficiency was 13.0%in EHBF≥1.0 L/min group and 45.5%in<1.0 L/min group,the difference was statistically significant(P<0.05).The area under the ICG R15 ROC curve was 0.710(95%CI:0.616-0.804),the critical value was 7.6,the sensitivity was 78.0%,and the specificity was 59.8%.The area under the EHBF ROC curve was 0.718(95%CI:0.624-0.813),the critical value was 0.35,the sensitivity was 73.2%,and the specificity was 70.7%.Conclusion:EHBF can effec-tively predict the occurrence of liver insufficiency after hepatocellular carcinoma operation,and may have the same testing efficacy as ICGR15.

关键词

肝肿瘤/肝储备功能/肝功能不全/肝有效血容量/吲哚菁绿

Key words

Hepatocellular carcinoma/Liver reserve function/Liver insufficiency/Effective he-patic blood flow/Indocyanine green

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基金项目

吴阶平医学基金会肝病医学部肝功能评估方法研究基金(LDWTPMF-104-2017006)

出版年

2024
中国现代普通外科进展
山东大学

中国现代普通外科进展

CSTPCD
影响因子:0.993
ISSN:1009-9905
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