摘要
目的:探讨肝脏切除术后标准残肝体积(standard remnant liver volume,SRLV)大小与患者术后肝功能代偿不全的关系.方法:对我院2007-03/2008-02收治的75例因肝癌行肝切除术的患者进行研究,术前采用CT测定患者的全肝体积,术中被切除的肝脏组织的体积由排水法测定,全肝体积与术中切除肝脏组织体积之差除以患者的体表面积即为标准残肝体积.根据术后患者肝功能代偿状况进行分组,比较不同组间标准残肝体积均数的差异;并根据标准残肝体积再分组,比较组间术后发生肝功能中、重度代偿不全发生率的差异.结果:术后肝功能轻度代偿不全组60例,中度代偿不全组12例,重度代偿不全组3例(因重度代偿不全组例数过少,纳入中度代偿不全组进行统计分析).术后肝功能轻度代偿不全组标准残肝体积均值为545±93mL/m2,而术后肝功能中、重度代偿不全组仅为398±82mL/m2,两者间比较有统计学差异(P<0.001),术后发生肝功能中、重度代偿不全患者标准残肝体积较小.按标准残肝体积416mL/m2为界将所有患者分为两组,A组SRLV≤416mL/m2,而B组SRLV>416mL/m2,两组术后肝功能中、重度代偿不全发生率分别为68.8%和6.8%,组间差异有显著性意义(P<0.001),SRLV≤416mL/m2术后肝功能中、重度代偿不全发生率较高.结论:标准残肝体积是评估肝切除术患者肝脏储备功能的有效且简便的方法,对预测患者术后发生肝功能损害的程度及避免患者术后发生肝功能衰竭有重要的临床指导作用.
AIM：To investigate the relationship between the size of standard remnant liver volume （SRLV） and liver insufficiency after liver resection.METHODS：Seventy-five patients with hepatocellular carcinoma who underwent liver resection from March 2007 to February 2008 at West China Hospital were included in our study.All the patients received CT examination to estimate the total liver volume before operation.The volume of resected liver during the operation was estimated by drainage.The standard remnant liver volume was expressed as the difference between the total liver volume and the resected liver volume divided by the body surface area of patients.The patients were divided into two groups based on the level of liver function compensation after hepatectomy to compare the differences in standard remnant liver volume.Then the patients were divided into two groups according to standard remnant liver volume to compare the incidence of moderate and severe liver insufficiency.RESULTS：Mild,moderate and severe liver insufficiency was noted in 60,12 and 3 patients,respectively.The average standard remnant liver volume was significantly higher in patients with mild liver insufficiency than in those with moderate or severe liver insufficiency （545 mL/m2 ± 93 mL/m2 vs 398 mL/m2 ± 82 mL/m2）.According to the standard remnant liver volume,the patients were divided into two groups：group A （≤ 416 mL/m2） and group B （ 416 mL/m2）.The incidence of moderate and severe liver insufficiency was significantly higher in the group A than in the group B （68.8% vs 6.8%）.CONCLUSION：Standard remnant liver volume （SRLV） is an effective parameter to evaluate hepatic function reserve in patients undergoing hepatectomy and can be used to predict and avoid liver dysfunction after hepatectomy.
出处
《世界华人消化杂志》
CAS
北大核心
2010年第17期1829-1833,共5页
World Chinese Journal of Digestology
关键词
标准残肝体积
肝切除术
肝功不全
Standard remnant liver volume
Liver resection
Liver insufficiency
