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目的:探讨肝癌肝脏切除手术后肝脏功能恢复影响因素,并建立风险预测模型。方法:回顾性分析2015年2月—2016年9月间行半肝切除手术的50例肝癌患者术的相关临床资料,通过单变量与多变量分析对筛选出可能影响肝癌患者术后肝脏功能恢复的因素,用所得各因素及其统计值建立风险预测模型。结果:患者手术前吲哚菁绿15分钟滞留率(ICGR15)、清除指数(HH15)、残余肝脏体积/标准肝脏体积(RLV/SLV)均为半肝切除手术后肝脏功能恢复的独立危险因素(P=0.002、P<0.001、P=0.007);所得到的风险预测模型为:风险系数(R)=31.871×(RLV/SLV)-1.689×(ICG R15)-19.663×HH15;R的临界值为0.90时,其预测术后出现肝功能不全的ROC曲线下面积为0.96,敏感度和特异度为97.5%和90%。结论:较低的RLV/SLV以及较高的ICGl5R和HH15是肝癌患者行肝脏切除术后肝功能不全的危险因素,所建立的预测模型有一定的风险评估价值。
Objective: To investigate the influencing factors of liver function recovery after hepatectomy of liver cancer and to establish a risk prediction model. Methods: The clinical data of 50 patients with HCC undergoing partial hepatectomy between February 2015 and September 2016 were retrospectively analyzed. Univariate and multivariate analyzes were performed to screen out the possible changes of postoperative liver function in HCC patients Of the factors, using the resulting factors and their statistical values to establish risk prediction model. Results: ICGR15, HH15, RLV / SLV were all independent risk factors of liver function recovery after hepatectomy P = 0.002, P <0.001, P = 0.007). The risk prediction model was as follows: Risk coefficient R = 31.871 × RLV / SLV -1.689 × ICG R15 -19.663 × HH15; Was 0.90, the predicted area under the ROC curve for postoperative liver dysfunction was 0.96, with a sensitivity and specificity of 97.5% and 90%. Conclusions: Lower RLV / SLV and higher ICG15R and HH15 are risk factors for liver dysfunction after hepatectomy in patients with liver cancer. The established prediction model has certain risk assessment value.