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肝癌手术前对患者肝功能的了解极为重要.这是由于手术过程中的麻醉、出血、低血压、肝血流量改变、机械损伤以及有功能肝实质的切除等,对肝功能均为沉重的打击.因此,肝外科医师不仅应了解患者肝功的现状,还须掌握肝功能的潜力大小——肝功能储备,从而判断肝最大安全可切除量,选择可耐受的术式.正常肝脏有巨大功能储备,即便切除80～90%,余肝通过功能代偿仍能维持机体的生存.然肝硬化者肝功储备严重受损,极小的手术干扰亦可招致肝功能衰竭而死亡.肝癌患者肝硬化伴发率甚高,因此从安全角度考虑的小范围肝切除和着眼于癌瘤根治的扩大切除构成了一对矛盾,而术前正确估价肝功储备即成为肝癌外
Liver cancer before surgery is extremely important for patients with liver function, which is due to the surgical process of anesthesia, bleeding, hypotension, changes in liver blood flow, mechanical damage and functional resection of liver parenchyma, are all on the liver function are heavy blow Therefore, the liver surgeon should not only understand the status quo of patients with liver function, but also grasp the potential of liver function size - reserve of liver function, so as to determine the maximum safe resection of the liver, choose tolerable surgery. Functional reserve, even if the removal of 80 to 90%, the remaining liver can still maintain the body through the functional compensation of survival.However, severe liver injury in liver reserve, minimal surgical interference can lead to liver failure and death.Hepatocellular carcinoma patients Cirrhosis with high incidence, so from a safety point of view of small-scale liver resection and focus on cancer radical expansion of the resection constitutes a pair of contradictions, and preoperative correct assessment of liver function reserves that become outside of liver cancer