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目的 探讨CT肝硬度分级评估肝癌术前肝储备功能的价值。方法 前瞻性研究原发性肝癌手术病人术前肝脏双期增强CT59例。术前确定肝硬度分级,与术后病理肝纤维化分级、临床肝功能分级、术前术后生化指标变化曲线和生存率进行级间差异性分析。结果 CT分级 1级与 2、3级之间的生存率差异有统计学意义(χ2 值分别为 4.9881和 5.4286,Ρ<0.05); CT分级之间的术后谷丙转氨酶(ALT)、谷草转氨酶(AST)和前白蛋白(PAB)水平峰值或谷底或 20d后的时间区段内,差异有统计学意义。CT分级与病理肝纤维化分级相关系数r=0.77(Ρ<0. 0001),与C-P分级的相关系数r=0.46(Ρ=0. 0011)。结论 肝硬度CT分级可以作为临床肝癌术前评估肝储备功能的重要指标之一。
Objective To investigate the value of CT liver cirrhosis grading in assessing preoperative liver reserve function of liver cancer. Methods The prospective study of primary liver cancer surgery patients with preoperative double hepatic CT59 cases. The grade of liver cirrhosis was determined preoperatively, and the postoperative pathological grade of liver fibrosis, clinical grade of liver function, the change of biochemical indexes and the survival rate before and after operation were analyzed. Results There were significant differences in the survival rates between CT grade 1 and grade 2 and 3 (χ2 = 4.9881 and 5.4286, respectively, P <0.05). Postoperative ALT, AST, (AST) and prealbumin (PAB) levels in the peak or valley or 20d after the time interval, the difference was statistically significant. The correlation coefficient between CT classification and pathological grade of hepatic fibrosis was r = 0.77 (P <0.0001), and the correlation coefficient with C-P grade was 0.46 (P = 0.001). Conclusions CT grading of liver cirrhosis can be used as one of the important indexes for assessing liver reserve function before operation in clinical liver cancer.