高杨;张熙冰;张春平;冯超;张升宁;
GAO Yang;ZHANG Xibing;ZHANG Chunping;FENG Chao;ZHANG Shengning;Hepatobiliary and Pancreatic Vascular Surgery of Kunming First People's Hospital;

• 1:昆明市第一人民医院肝胆胰血管外科

摘要(Abstract)：

目的:探讨合并乙型肝炎的肝细胞癌切除术前Fibro Scan弹性值(FS)与术后肝衰竭严重程度及预后的相关性。方法:分析300例合并乙型肝炎的肝细胞癌患者肝切除术后肝衰竭发生情况,采用肝脏瞬时弹性超声成像仪获取每位患者的FS,分析FS与术后肝衰竭严重程度及预后的相关性;绘制FS、肝衰竭程度评价指标(CTP)评分、终末期肝病模型(MELD)积分对术后肝衰竭患者预后诊断价值的ROC曲线,计算对肝衰竭预后诊断的敏感性、特异性、准确性、阳性预测值和阴性预测值。结果:300例合并乙型肝炎的肝细胞癌手术患者中共有72例患者术后发生肝衰竭,肝衰竭严重程度与FS呈正相关(P<0.05);FS与CTP评分、MELD积分呈正相关(P<0.05),FS、CTP评分、MELD积分对肝衰竭预后均具有较好的诊断准确性。结论:合并乙型肝炎的肝细胞癌切除术前FS与术后肝衰竭严重程度密切相关。
Objective: To discuss the correlation of Fibro Scan elasticity before resection of hepatocellular carcinoma complicated with hepatitis B associated with severity and prognosis of postoperative liver failure. Methods: The occurrence of hepatic failure after hepatectomy in 300 patients with hepatocellular carcinoma complicated with hepatitis B was analyzed,and the Fibro Sean elasticity of each patient was obtained by the liver instantaneous elastic ultrasound imager. The correlation between Fibro Scan elastic value( FS) and the severity as well as prognosis of postoperative liver failure was analyzed. FS value,evaluation index of the degree of liver failure( CTP),and ROC curve of MELD integral in the prognosis of patients with postoperative liver failure were drawn. The sensitivity,specificity,accuracy,positive and negative predictive value were calculated for the prognosis of liver failure.Results: 72 of 300 patients with hepatocellular carcinoma complicated with hepatitis B developed liver failure after operation. The severity of liver failure was positively correlated with Fibro Scan elasticity( P < 0. 05). FS value was positively correlated with CTP score and MELD integral. The FS value,the CTP score,and the MELD integral had good diagnostic accuracy for the prognosis of liver failure.Conclusion: FS value before resection of hepatocellular carcinoma complicated with Hepatitis B is closely related to the severity of postoperative liver failure.

关键词(KeyWords)： 肝炎,乙型;癌,肝细胞;肝功能衰竭;FibroScan弹性值;CTP评分;MELD积分
hepatitis B;carcinoma,hepatocyte;liver function failure;FibroScan elasticity;CTP score;MELD integral

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 高杨;张熙冰;张春平;冯超;张升宁;
GAO Yang;ZHANG Xibing;ZHANG Chunping;FENG Chao;ZHANG Shengning;Hepatobiliary and Pancreatic Vascular Surgery of Kunming First People's Hospital;

Email:

DOI: 10.19367/j.cnki.1000-2707.2018.01.026

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