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背景与目的:术前正确评估肝脏储备功能,是避免肝癌患者术后肝功能衰竭的重要措施。近年来,吲哚靛青绿储留率(indocyaninegreenretentionrateat15min,ICGR15)被认为能准确而灵敏地反映肝脏储备功能。本研究目的探讨肝癌切除术前ICGR15在评估肝硬化程度和肝脏储备功能中的作用,分析ICGR15与术后肝功能不全的关系,并与Child-Pugh分级进行比较。方法:分析225例手术切除的肝细胞癌患者术前常规肝功能检查、Child-Pugh分级及ICGR15的测定结果。结果:肝硬化患者及无肝硬化患者ICGR15均值分别为(9.90±6.20)%、(7.41±3.80)%,差异有显著性(P<0.01);轻、中、重度肝硬化患者的ICGR15均值分别为(8.49±5.00)%、(10.70±5.70)%、(15.77±9.60)%,三组间两两比较差异有显著性(P<0.05);术后发生腹水、黄疸患者的ICGR15均值分别为(11.49±6.80)%、(12.09±7.10)%,分别显著高于无腹水、无黄疸患者(8.53±4.90)%、(8.96±5.30)%(P<0.05)。将可能影响术后并发症发生的多种因素以enter法引入多元logistic回归模型,ICGR15对术后发生腹水、黄疸均有显著影响(P<0.05)。Child-PughB级患者的ICGR15均值为(15.25±8.60)%,显著高于Child-PughA级患者(8.85±5.10)%(P<0.01);212例Child-PughA级患者中有67例ICGR15大于10%,其中6例大于
BACKGROUND & AIM: Correct assessment of liver reserve function before surgery is an important measure to prevent postoperative liver failure in patients with liver cancer. In recent years, indocyanine green potential retention at15min (ICGR15) is considered to accurately and sensitively reflect liver reserve function. The purpose of this study was to investigate the role of ICGR15 in assessing the degree of liver cirrhosis and liver reserve function before resection of liver cancer and to analyze the relationship between ICGR15 and postoperative liver dysfunction and to compare with Child-Pugh classification. Methods: Preoperative routine liver function tests, Child-Pugh grading and ICGR15 results were analyzed in 225 patients with HCC. Results: The mean of ICGR15 in patients with cirrhosis and without cirrhosis was (9.90 ± 6.20)% and (7.41 ± 3.80)%, respectively, with significant difference (P <0.01) (8.49 ± 5.00)%, (10.70 ± 5.70)% and (15.77 ± 9.60)%, respectively, and there was significant difference between the three groups (P <0.05). The mean ICGR15 values of ascites and jaundice after operation were (11.49 ± 6.80)% and (12.09 ± 7.10)%, respectively, which were significantly higher than those without ascites and without jaundice (8.53 ± 4.90% vs 8.96 ± 5.30%, P <0.05). Multivariate logistic regression model was introduced by enter method, which could affect the postoperative complications. ICGR15 had significant effect on postoperative ascites and jaundice (P <0.05). The mean ICGR15 in Child-Pugh class B patients was (15.25 ± 8.60)%, significantly higher than that in Child-Pugh class A patients (8.85 ± 5.10)% (P <0.01) %, Of which 6 were greater than