摘要
目的探讨血清前白蛋白（prealbumin，PA）水平与肝功能Child-Pugh分级的相关性，以及在肝炎后肝硬化患者围手术期的病情评估中的临床价值。方法对肝炎后肝硬化29例患者行Child-Pugh评分分级，同时动态检测其入院时、术前日、术后1d、术后3d以及术后1周的PA值及术后的并发症情况。结果PA值在不同肝功能分级之间差异有统计学意义，且与Child-Pugh分级呈明显负相关。Child-Pugh分级越差，其PA值越低，术后并发症发生率高，术后恢复慢。动态检测PA值显示，术后患者PA值多出现下降，术后若PA值显著升高，病情多趋于好转，PA值不升或下降，患者病情重，并发症发生率高。结论动态监测肝炎后肝硬化患者围手术期PA值的变化，联合Child-Pugh肝功能分级可以有效评估肝硬化的肝功能，在肝炎后肝硬化患者的病情判断及预后的评估上有重要的临床价值。
Objective To investigate the correlation between prealbumin （PA）level and Child- Pugh classification and their clinical value in the assessment of patients with posthepatitic cirrhosis （PC） during the perioperative period. Methods A total of 29 patients with PC were classified according to the Child-Pugh classification. At the same time, the level of PA was dynamically evaluated on admission, pre- operative day 1, and postoperative day 1,3 and 7. Postoperative complications were also assessed. Results The levels of PA of in patients with different Child-Pugh classification were significantly different, and there was a negative correlation between the PA and Child-Pugh. The worse Child-Pugh classification was accompanied with a lower PA level,higher incidence of postoperative complications, and slower postopera- tive recovery. Dynamic monitor of PA value showed that the PA value of most PC patients declined postop- eratively. When the postoperative PA value increased obviously, the patient~ condition was improved. When the postoperative PA value stayed or declined, the patient~ condition tended to get worse and might have a high incidence of complications. Conclusion The dynamic monitor of the postoperative PA value and Child-Pugh score can assess the liver function of patients with cirrhosis effectively, which has important clinical value in the assessment of the condition and prognosis of PC patients.
出处
《临床外科杂志》
2012年第12期856-858,共3页
Journal of Clinical Surgery
