Child-Pugh分级联合ICG与肝瞬时弹性值评估肝部分切除术肝细胞癌患者肝储备功能

摘要

目的探讨以肝瞬时弹性值（Fibroscan）和吲哚氰绿试验（ICG measurement）补充Child-Pugh分级形成的肝储备功能新评分系统在评估原发性肝细胞癌患者肝储备功能中的可行性。方法选择2011年10月至2012年10月间本科室接受肝部分切除原发性肝细胞癌病例93例，分别于术前及术后1个月内以Child-Pugh分级与新评分系统评估肝储备功能，了解两种方法预测术后肝功能代偿情况的准确率。结果Child-Pugh预测术后肝功能代偿良好准确率为62.22%，新分级预测术后肝功能代偿良好准确率为83.33%（P=0.033）；Child-Pugh预测术后肝功能代偿轻度不良准确率为64.58%，新分级预测术后肝功能代偿轻度不良准确率为87.23%（P=0.009）。结论新分级系统较Child-Pugh评分能够更全面评价原发性肝细胞癌合并肝硬化患者围手术期肝储备功能。%Objective To investigate the feasibility of hepatic reserve function evaluation by new classiifcation based on Child-Pugh combination with Fibroscan and ICG measurement. Methods From October 2011 to October 2012, 93 patients with hepatocellular carcinoma (HCC) were evaluated by Child-Pugh classiifcation and new classification for their pre-and-post operative hepatic reserve function, and the precision of two classiifcations to predict hepatic functional compensation were measured. Results The precision of Child-Pugh classiifcation to predict hepatic functional compensation and mild hepatic functional decompensation was 62.22%and 64.58%, respectively, which were 83.33%and 87.23%for new classiifcation, respectively. Conclusions New classiifcation is better than Child-Pugh classiifcation in evaluating hepatic reserve function for HCC patients complicated with liver cirrhosis.