肝硬變門靜脈高壓癥患者肝體積測量研究及其臨床意義_《中國普外基礎與臨床雜志》

作者：

王茂春 , 冷希圣 , 彭吉潤 , 朱繼業 , 杜如昱

北京大學人民醫院肝膽外科中心（北京100044）;

關鍵詞：

肝硬變門靜脈高血壓肝體積測量

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目的探討用個人電腦及自行開發的軟件對肝臟CT斷層圖像進行三維重建和測量及其在肝硬變門靜脈高壓癥患者中的臨床意義。方法術前對46例行原位肝移植的肝硬變門靜脈高壓癥患者和30例正常對照者的肝臟CT斷層圖像進行三維重建和測量，術后與肝硬變門靜脈高壓癥患者切除的受體實測肝體積進行對比分析。結果 46例肝硬變門靜脈高壓癥患者用本方法測得平均肝臟體積為(983.33±206.11) cm3，同組實測平均肝臟體積為(904.93±209.56) cm3，二者之間呈高度正相關(r=0.969, P＜0.01），本方法測定值的平均誤差為8.66%。正常對照組用本方法測得平均肝臟體積為(1 287.00±96.18) cm3, 與其身高、體重和體表面積之間均存在著正相關關系(r值分別為0.845、0.833和0.932,P＜0.01）。肝硬變門靜脈高壓癥患者肝臟體積與ChildPugh分級有關, C級患者肝臟體積明顯小于B級者；也與血漿白蛋白水平呈顯著正相關（r＝0.496,P＜0.01），與總膽紅素水平（r＝-0.493,P＜0.01）及凝血酶原時間(r＝-0.517,P＜0.01）呈顯著負相關，與ALT值（r＝0.206，P gt;0.05）、門靜脈壓力（r＝-0.093，P＝0.539）及門體自然分流指數(r＝0.044，P＝0.769)無明顯相關關系。結論運用該方法對肝臟CT斷層圖像進行三維重建和測量準確性較高。肝臟體積大小與肝功能有密切關系，肝臟體積可較敏感地反映肝臟儲備功能狀況。

引用本文： 王茂春,冷希圣,彭吉潤,朱繼業,杜如昱. 肝硬變門靜脈高壓癥患者肝體積測量研究及其臨床意義. 中國普外基礎與臨床雜志, 2003, 10(6): 586-588. doi: 復制

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1. Adler M, Van Laethem J, Glibert A, et al. Factors influencing survival at one year in patients with nonbiliary hepatic parenchymal cirrhosis [J].Dig Dis Sci, 1990; 35(1)∶1.
2. Albers I,Hartmann H, Bircher J, et al. Superiority of the ChildPugh classification to quantitative liver function tests for assessing prognosis in liver cirrhosis [J].Scand J Gastroenterol, 1989; 24(3)∶269.
3. Galambos JT. Evaluation of patients with portal hypertension [J].Am J Surg, 1990; 160(1)∶14.
4. Zoli M, Cordiani MR, Marchesini G, et al. Prognostic indicators in compensated cirrhosis [J].Am J Gastroenterol, 1991; 86(10)∶1508.
5. 胡永梅，武曉洛，胡志紅，等. 關于中國人體表面積公式的研究 [J].生理學報， 1999; 92(1)∶45.
6. Redvanly RD, Nelson RC, Stieber AC, et al. Imaging in the preoperative evaluation of adult livertransplant candidates: goals,merits of various procedures, and recommendations [J].AJR Am J Roentgenol, 1995; 164(3)∶611.
7. Ogasawara K, Une Y, Nakajima Y, et al. The significance of measurring liver volume using computed tomographic images before and after hepatectomy [J].Surg Today, 1995; 25(1)∶43.
8. Ros PR, Elrahman MM, Barreda R, et al.Threedimensional imaging of liver masses: preliminary experience [J]. Appl Radiol, 1990; 19(1)∶28.
9. Heymsfield SB, Fuleonwider T, Nordlinger B, et al. Accurate measurement of liver, kidney and spleen volume and mass by computerized axial tomography [J].Ann Intern Med, 1979; 90(2)∶185.
10. Van Thiel DH, Hagler NG, Schade RR, et al.In vivo hepatic volume determination using sonography and computed tomography [J].Gastroenterology, 1985; 88(6)∶1812.
11. Caldwell SH, de Lange EE, Gaffey MJ, et al. Accuracy and significance of pretransplant liver volume measured by magnetic resonance imaging [J]. Liver Transpl Surg, 1996; 2(6)∶438.
12. Fritschy P, Robotti G, Schneekloth G, et al. Measurement of liver volume by ultrasound and computed tomography [J]. J Clin Ultrasound, 1983; 11(6)∶299.

《中國普外基礎與臨床雜志》

肝硬變門靜脈高壓癥患者肝體積測量研究及其臨床意義

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《中國普外基礎與臨床雜志》

肝硬變門靜脈高壓癥患者肝體積測量研究及其臨床意義

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

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