ObjectiveTo investigate the effect of indocyanogen green retention rate (ICGR) measurement and Child-Pugh classification of liver function in the preoperative evaluation of hepatic functional reservation. MethodsThe level of ICGR at 15 min (ICGR15) and the percentage of liver fibrosis in 103 patients with liver cancer were measured before hepatectomy, and the Child-Pugh classification of liver function was evaluated before and after the operations, and their connections were analyzed. ResultsAs the rise of Child-Pugh classification of liver function, the percentage of liver fibrosis increased gradually, there were significant differences between any two Child-Pugh classification (Plt;0.05). There was a linear correlation between the ICGR15 and the liver fibrosis percentage (rs=0.960, Plt;0.05). The value of preoperative ICGR15 in patients with postoperative Child-Pugh classification from grade A to grade B or grade B to grade C was gnificantly higher than that in patients with stabilization of Child-Pugh classification before and after operations (Plt;0.05). ConclusionICGR15 combined with Child-Pugh classification can improve the accuracy for the evaluation of preoperative hepatic functional reservation.
The experimental models of chronic hepatic lesion of 40 rabbits were made by intra-abdominal injection of thioacetamide.The chronic hepatic lesion was confirmed by pathological examination and hepatectomies were performed in accordance with different measurements on each rabbit.The observations included indocyanine green retention rate,hepatic resection volume,and the outcomes of operations.The results showed that the mortality was correlative with the change of hepatic functions in the background of chronic hepatic lesion.The indocyanine green retention and the level of serum albumin are important parameters to indicate hepatic impairment.When the former was over 40% or the latter below 2.8g% the operative danger was high and the mortality was over 50%.In accordance with the classification of hepatic function,the preoperative functional state of liver were classified:grade A,B and C.the mortality of posthepatectomy were respectively 16.7%,3O%,and 72%.The multiple progressive regression equation is employed for calculating the postoperative outcome.The equation predicted the postoperative outcome with 88.9% accuracy.
【 Abstract 】 Objective To explore the effect of gamma-globulin in evaluating hepatic functional reservation in patients with liver tumor. Methods Serum protein electrophoresis (SPE) was performed on 30 patients with liver tumor to get gamma-globulin and preoperative Child-Pugh classification. Then the relations between gamma-globulin and preoperative and postoperative Child-Pugh classification were studied. While with gamma-globulin as evaluating standard, the validity compared with Child-Pugh classification were studied. Results The gamma-globulin was lower in classification A patients 〔（ 21.053 3 ± 6.001 4)% 〕 than that in classification B 〔 (28.800 0 ± 8.672 5)% 〕 before operation. While the gamma-globulin 〔 (21.022 0 ± 5.354 6)% 〕 of classification A patients after operation was also lower than that of classification B/C 〔 (29.556 0 ± 7.698 5)% 〕 . These differences were significant (P ＜ 0.05). With gamma-globulin gt;30% as evaluating standard ， the sensitivity and specificity were 80.00% and 96.00%, respectively. Conclusion Gamma-globulin can reflect hepatic functional reservation in patients with liver tumor. Combining gamma-globulin and Child-Pugh classification can evaluate hepatic functional reservation more objectively.