原发性肝癌切除术后发生肝功能代偿不全的临床研究

目的: 探讨了解肝部分切除术后出现肝功能不全的可能原因. 方法: 将63例原发性肝癌患者分成3组,比较分析各组的手术后生存时间与生存率、术后复发率、术前、术后的主要肝功能指标,术后一年内出现肝功能不全的原因与频率,以及死亡患者的死亡原因与时间等. 结果: 平均随访时间为(25±21.3)个月,各组生存率无显著性差异,总复发率为56%(35/63),平均复发时间为17个月;术后死于复发癌的时间为(22±12.3)个月,死于肝功能不全的时间为(4.8±3.7)个月,术前肝功能储备差者,术后易发生代偿不全,术后早期死亡者大多由肝功能不全所致. 结论: 对原发性肝癌病人行肝部分切除术时,要充分了解肝功能储备,术后早期积极给予保肝治疗.

Causes of hepatic failure after partial hepatectomy in patients with primary liver cancer

Objective:In order to realize the possible cause of hepatic failure after partial hepatectomy in the patient with primary liver cancer.Methods:Sixty three patients with PLC who underwent partial hepatectomy were divided into three groups by liver function before operation. The survival time,survival rate and recurrence rate after operation,the main hepatic function values before and after hepatectomy,cause and frequence of hepatic failure with 1 year after operation and the cause and time of the dead patients were observed and compared among three groups.Results:There was no significant difference in survival rate and recurrence rate after operation among 3 groups. Hepatic failure within 1 year after hepatectomy was observed in 23.3%,68.4% and 14.3% in groups G1,G2 and G3 respectively,and the frequency of occurrence of hepatic failure in G2 was significantly higher than those of G1 and G3. Serum albumin levels recovered from the decline after hepatectomy in G1 and G3,on the other hand,no recovery was found in G2.Conclusion:Poor liver function before operation was thought to be the major reason for the frequent occurence of hepatic failure after hepatectomy for hepatocelluar carcinoma with liver cirrhosis.