ICGR15在肝癌切除术前评估肝脏储备功能的作用

目的 探讨快速肝储备功能检测系统(DDG)中ICGR15在肝癌切除术前评估肝储备功能的作用.方法 从2005年8月至2007年10月收治66例肝癌切除病人,随机将病人分为ChildPugh评分组和ICGR15组,比较两组术后肝功能不全发生率的变化和分析Child-Pugh评分与ICGR15的关系.结果 Child-Pugh评分组术后出现腹水11例,黄疸8例,肝性脑病5例,死亡2例,肝功能不全发生率为34.4%;ICGR15组术后出现腹水8例,黄疽4例,肝性脑病2例,死亡0例,肝功能不全发生率为23.5%;两组肝功能不全发生率相比有显著性差异(P<0.05);ICGR15组Child-PughB级病人ICGR15均值为(14.38±8.2)%,显著高于Chitd-Pugh A级病人(7.84±4.8)%(P<0.01).结论 Child-Pugh评分与ICGR15值有密切关系,但ICGR15较Child-Pugh评分能更准确,灵敏地评估肝脏储备功能,对决定肝癌切除范围和手术预后的评估有指导作用.

Role of ICGR15 detection in assessment of hepatic functional reserve before hepatectomy for hepatocellular carcinoma

Objective To evaluate the role of ICGR15 in assessment of hepatic functional reserve before hepateetomy for hepatocellular carcinoma.Methods From August 2005 to October 2007, six-ty-six patients with hepatocellular carcinoma were treated in our hospital.The patients were random-ized into Child-Pugh grading group (32 cases) and ICGR15 detection group (34 cases).Preoperative preparation,operative procedures and postoperative management were the same in all the 66 patients.The morbidity and mortality were compared and the relationship between Child-Pugh grading and ICGR15 in assessment of hepatic functional reserve was determined.Results The incidence of hepatic failure after hepatectomy in ICGR15 detection group(23.50%) was significanly lower than that in Child-Pugh grading group(34.4%).ICGR15 (14.38 ±8.2)% in patients with tumor of Child-Pugh grading B was higher than ICGR15 (7.84 ± 4.8)% in those with tumor of Child-Pugh grading A.Conclusion ICGR15 valuecan be more sensitive in evaluating hepatic functional reserve than Child-Pugh grading, but some correlation can be observed between them.ICGR15 is useful in assessing the range of liver resection and prognosis before hepatectomy for hepatocellular carcinoma.