论文部分内容阅读
目的介绍一种肝储备功能与肝脏有效血流量(effective hepatic blood flow,EHBF)的检测方法,探讨其临床意义。方法采用脉动色素浓度测定法(pulse dye densitometry,PDD)和传统的分光光度仪比色法同时检测92例患者吲哚菁绿(indocyanine green,ICG)15min滞留率(ICGR15),分析检测结果的相关性;采用PDD法检测1181例肝癌、85例门脉高压和120例肝血管瘤患者ICGR15、ICG清除率(K)、全身血容量(BV)、心输出量(CO)及EHBF。结果PDD测定法检测的ICGR15与分光光度仪比色法的测定结果显著相关(y=0.789x+2.109,r=0.945,P<0.01)。肝癌和门脉高压患者EHBF较肝血管瘤组显著降低,ICGR15和CO显著升高。ICGR15值小于10%的肝癌患者EHBF平均为1.233L/min,EHBF随着ICGR15的升高显著降低;60岁以上肝癌患者K值、CO和EHBF较60岁以下组均显著降低。结论脉动色素浓度测定法具有无创、实时、便捷等优点,检测的各项数据对评估肝储备功能和EHBF,把握手术方式和范围有一定的参考价值。
Objective To introduce a method to detect liver reserve function and effective hepatic blood flow (EHBF), and to explore its clinical significance. Methods The determination of ICGR15 in indocyanine green (ICG) in 92 patients by pulse dye densitometry (PDD) and traditional spectrophotometer colorimetry was performed simultaneously. The correlation between the detection results The ICGR15, ICG clearance (K), total body volume (BV), cardiac output (CO) and EHBF of 1181 patients with liver cancer, 85 patients with portal hypertension and 120 patients with hepatic hemangioma were detected by PDD. Results The results of PDD assay ICGR15 were significantly correlated with the results of spectrophotometer colorimetry (y = 0.789x + 2.109, r = 0.945, P <0.01). EHBF was significantly lower in hepatocellular carcinoma and portal hypertension than that in hepatic hemangioma, and ICGR15 and CO were significantly increased. The EHBF of patients with ICGR15 less than 10% was 1.233L / min and the EHBF was significantly decreased with the increase of ICGR15. The K values, CO and EHBF of patients with liver cancer over 60 years old were significantly lower than those under 60 years old. Conclusion Pulsed dye concentration has the advantages of noninvasive, real-time and convenient. The data of the test have some reference value to evaluate the liver reserve function and EHBF, and to grasp the operation mode and scope.