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本文推荐了一种术中主要按照肝表面最大硬化结节大小评估肝硬化程度的分级标准。肝脏表面最大硬化结节直径<0.4 cm 为轻度肝硬化;0.4～0.8 cm 为中度肝硬化;>0.8 cm,或肝脏明显缩小变形,为重度肝硬化。按照此标准分级,统计表明随着肝硬化程度的加重,尽管手术切除的肝组织量减少,但术后出现肝功不全(尤其是重度肝功不全)发生率逐渐增加。提示根据我们的标准进行肝硬化的分级,术中评估肝储备功能有临床实用价值,有助于选择适当的手术方式,减少肝功能衰竭的发生。
This article proposes a grading standard that assesses the extent of cirrhosis primarily based on the size of the hepatic surface maximal hardened nodule. Liver surface maximum hardened nodule diameter <0.4 cm for mild cirrhosis; 0.4 ~ 0.8 cm for moderate cirrhosis;> 0.8 cm, or significantly reduced liver deformation, severe cirrhosis. According to the classification of this standard, statistics show that as the degree of liver cirrhosis worsens, the incidence of hepatic insufficiency (especially severe hepatic insufficiency) increases gradually after surgery, although the amount of liver tissue removed by surgery is reduced. The classification of liver cirrhosis according to our standards suggests that the evaluation of liver reserve function during the operation has clinical value, which is helpful to select the appropriate surgical method and reduce the occurrence of hepatic failure.