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目的 阐明围手术期肝功能对肝癌根治术后病人预后的影响。方法 对 96例病人围手术期肝功能和其他临床病理特征进行生存率的比较 (单因素分析 ) ,并通过Cox多因素分析得到有独立意义的肝功能预后指标。结果 单因素分析示在肝功能指标中 :围手术期白 /球蛋白比 (A/G)、碱性磷酸酶 (AKP)、术前白蛋白、γ 谷氨酰转肽酶 (GGT)、术后一周胆汁酸浓度 (SBA)、丙氨酸转氨酶(ALT)与生存率相关 (P <0 0 5 )。Cox多因素分析示 :术后一周ALT是与生存相关的独立预后因素。另外单因素分析示术前A/G、GGT、AKP、术后一周SBA与无瘤生存率相关。多因素分析示术后一周胆汁酸浓度是与无瘤生存相关的独立预后因素。结论 围手术期肝功能对估计肝癌病人预后有一定作用 ,加强保肝治疗是提高生存率的重要方法之一
Objective To clarify the impact of perioperative liver function on the prognosis of patients with liver cancer after radical operation. Methods 96 patients with perioperative liver function and other clinicopathological characteristics of survival rate comparison (univariate analysis), and by Cox multivariate analysis of independent significance of liver function prognostic indicators. Results Univariate analysis showed that in the indexes of liver function, perioperative white / globulin ratio (A / G), alkaline phosphatase (AKP), preoperative albumin, gamma glutamyl transpeptidase (GGT) Bile acid concentration (SBA) and alanine aminotransferase (ALT) were associated with survival after a week (P <0.05). Cox multivariate analysis showed that ALT was an independent prognostic factor related to survival one week after surgery. In addition, univariate analysis showed preoperative A / G, GGT, AKP, one week after surgery SBA and tumor-free survival rate. Multivariate analysis showed that bile acid concentration was an independent prognostic factor associated with disease-free survival one week after surgery. Conclusion Perioperative liver function has a certain effect on the prognosis of patients with hepatocellular carcinoma. Strengthening hepatoprotective therapy is one of the important ways to improve the survival rate