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目的探讨肝脏恶性肿瘤精细介入前后肝储备功能评价的临床意义。方法选取2012年12月至2014年10月间河南省商丘市第一人民医院收治接受精细介入治疗的肝脏恶性肿瘤患者99例为研究对象,患者介入化疗栓塞前测定吲哚氰绿15 min滞留率(ICGR 15),根据ICGR 15测定结果分为ICGR 15<10%、ICGR 15 10%~30%和ICGR 15>30%三组。精细介入治疗后根据患者肝脏功能情况分为肝功能重度损伤和肝功能轻度损伤,比较治疗后不同ICGR 15水平患者的肝功能损伤情况,比较治疗后不同肝功能损伤患者的TBIL水平、ICGR 15水平和Child-Pugh评分,比较治疗前不同Child-Pugh分级患者的ICGR 15水平。结果精细介入治疗后,ICGR 15>30%组患者肝功能损伤的发生率明显高于ICGR 15<10%组患者,差异有统计学意义(P<0.05)。精细介入治疗后,肝功能重度损伤患者的ICGR 15水平明显高于肝功能轻度损伤患者的ICGR 15水平,差异有统计学意义(P<0.05),而TBIL水平、Child-Pugh评分比较,差异无统计学意义(P>0.05)。精细介入治疗前,Child-Pugh B级患者的ICGR 15水平明显高于Child-Pugh A级患者,差异有统计学意义(P<0.05)。结论 ICGR 15表达能够准确有效地评价肝脏恶性肿瘤精细介入前后肝储备功能,在肝储备功能的评估中具有很高的应用价值。
Objective To investigate the clinical significance of liver reserve function before and after fine interventional treatment of hepatic malignant tumor. Methods From December 2012 to October 2014, 99 patients with hepatic malignancies undergoing fine interventional therapy in the First People’s Hospital of Shangqiu City, Henan Province were enrolled in this study. The retention rate of indocyanine green 15 min before interventional chemotherapy was measured (ICGR 15) were divided into three groups of ICGR 15 <10%, ICGR 15 10% -30% and ICGR 15> 30% according to the results of ICGR 15 assay. After intensive interventional therapy, patients were divided into severe liver function damage and mild liver injury according to the liver function of the patients. The liver function injury of patients with different ICGR 15 levels after treatment was compared. The TBIL levels in patients with different liver injury after treatment were compared. ICGR 15 Levels and Child-Pugh scores were compared for ICGR 15 levels in patients with different Child-Pugh grading before treatment. Results After the interventional treatment, the incidence of hepatic injury in ICGR 15> 30% group was significantly higher than that in ICGR 15 <10% group (P <0.05). After intensive intervention, the level of ICGR 15 in patients with severe liver injury was significantly higher than that in patients with mild liver injury (P <0.05), while TBIL levels and Child-Pugh scores were significantly different No statistical significance (P> 0.05). Before intensive intervention, the level of ICGR 15 in Child-Pugh class B patients was significantly higher than that in Child-Pugh class A patients (P <0.05). Conclusion ICGR 15 expression can accurately and effectively evaluate the liver reserve function of liver malignant tumor before and after fine intervention, and has a high value in the evaluation of liver reserve function.