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相關文獻
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頁籤選單縮合
| 題 名 | Using Indocyanine Green Test to Avoid Post-hepatectomy Liver Dysfunction=應用靛氰綠滯留測試避免肝切除術後之肝衰竭 |
|---|---|
| 作 者 | 李正方; 游明晉; 郭亮鉾; 詹昆明; 詹益銀; 陳敏夫; 李威震; | 書刊名 | 長庚醫學 |
| 卷 期 | 30:4 2007.07-08[民96.07-08] |
| 頁 次 | 頁333-338 |
| 分類號 | 416.246 |
| 關鍵詞 | 肝癌; 肝切除; 靛氰綠滯留測試; 肝體積; Hepatocellular carcinoma; Hepatectomy; Indocyanine green test; Liver volume; |
| 語 文 | 英文(English) |
| 中文摘要 | 背景:肝衰竭是肝切除手術後最重要的問題。切除的肝體積必須根據病人本身之肝功能加以取捨;我們嘗試去分析肝切除術後殘 餘體積比(ratio of remnant liver volume; RR)和15分鐘靛氰綠滯留測試(indocyanine green test; ICG)之間與肝衰竭 的相關性是否存在。 方法:本研究共收錄在2002~2003年之間一百一十七例接受肝切除的肝癌患者。肝切除後殘餘體積比RR=LV-RV/LV*100%(LV:liver volume;RV:resected liver volume)。從身高體重換算成體表面積(body surface area;BSA)後,肝體積 LV 可由公式 LV (m1)=706.2*BSA(m2)+2.4得來;切除肝體積RV則根據病理科檢體報告估計。 結果:一百一十七位病人中共有十三例發生肝衰竭(定義為國際標準凝血時間比International Normailized Ratio (INR)>1.5) 將這十三例的病人RR和ICG作簡單線性迴歸,可得到公式:RR=1.98*ICG+0.3672(迴歸係數 r=0.92,p<0.001)。換言之,根 據病人不同之ICG可換算出可安全切除的最大範圍。其敏感度及專一度可達83%及92%。 結論:這個方法可以簡單預測肝臟切除手術的安全界線,但用於患有嚴重內科疾病人身上則必須更為保守。 |
| 英文摘要 | Background: Post-operative hepatic failure is the most important concern for hepatocellular carcinoma (HCC) patients undergoing hepatectomy. The aim of this study was to determine the safe line of hepatectomy to prevent liver failure. Method: Clinical profiles of 117 patients with HCC who underwent hepatectomies in Chang Gung Memorial Hospital from Jan. 2002 through Jun. 2003 were reviewed. Patients with heart disease, azotemia, intra-operative blood loss ≥ 1500 ml or international ratio of prothrombin time ≥ 1.2 were excluded. All 117 patients studied had preoperative 15-minute retention rates of ICG (ICG15). Whole liver volumes (LV) were calculated from the equation: LV (ml) = 706.2 x body surface area (BSA, m2) 2.4. The resected liver volumes were measured by pathologists. Postoperative liver dysfunction was defined as an international prothrombin ratio of ≥ 1.5. Results: Thirteen of the 117 HCC patients experienced postoperative liver dysfunction. The relationship between ICG15 retention rates and the ratio of remnant liver volume (RR) in the patients with postoperative liver dysfunction was established by regression, producing an equation: RR = 1.98 x ICG 0.3672 (r = 0.92, p < 0.001). Conclusion: Hepatectomies will be safer if the estimated ratio of remnant liver volume prior to surgery is higher than the calculated value of RR = 1.98 x ICG 0.3672. |
本系統中英文摘要資訊取自各篇刊載內容。