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目的探讨脾与残肝体积比在肝癌手术中对肝脏储备功能的评估价值。方法应用影像学方法和水浸法计算脾脏与肿瘤切除后残肝的体积比,分析脾与残肝体积比与患者术后肝功能情况及住院时间的关系。结果多元回归分析结果提示肝功能Child-Pugh评分与脾与残肝体积比有关,该比值越小,其评分越低(t=7.831,P=0.000),即肝功能越好。当脾与残肝体积比≤0.9时,患者中位住院时间为14 d(12～16 d),>0.9时为22 d(15～29 d),两者的住院时间差异有统计学意义(P=0.000)。结论脾与残肝体积比能有效评估肝脏的储备功能,预测肝癌手术后患者的恢复能力,当预计肝癌手术后脾与残肝体积比≤0.9时,手术可安全实施。
Objective To evaluate the value of liver to reserve function of liver and spleen in the volume ratio of spleen to remnant liver. Methods The volume ratio of residual liver after splenectomy and tumor resection was calculated by imaging method and water immersion method. The relationship between the volume ratio of splenic and residual liver and postoperative liver function and hospitalization time was analyzed. Results Multiple regression analysis showed that the Child-Pugh score of liver function was related to the volume ratio of spleen and residual liver. The lower the score was, the lower the score was (t = 7.831, P = 0.000), that is, the better liver function. When the volume ratio of spleen to liver was ≤ 0.9, the median length of hospital stay was 14 days (ranged from 12 to 16 days) and 22 days (ranged from 15 to 29 days) at> 0.9. There was significant difference in hospitalization time between the two groups P = 0.000). Conclusion The volume ratio of spleen to remnant liver can effectively evaluate the reserve function of liver and predict the recovery ability of patients after liver cancer surgery. When the volume ratio of spleen to remnant liver is less than or equal to 0.9, the surgery can be safely implemented.