Patel T
Division of Gastroenterology and Hepatology and Internal Medicine, Mayo Clinic Rochester, Minn., USA.
Mayo Clin Proc. 1999 Jun;74(6):593-9. doi: 10.4065/74.6.593.
Patients with liver disease often undergo surgery. With the increasing prevalence of liver disease and improved survival due to newer medications and treatments, a growing number of patients with liver disease will require preoperative assessment. Because of the multiple physiological roles of the liver, hepatic dysfunction places these patients at an increased risk of perioperative morbidity and mortality. The precise risks associated with specific liver diseases are poorly understood but are greater with increased impairment of hepatic function. Identifying preexisting problems that could be optimally and appropriately managed before surgery (e.g., coagulation status, intravascular volume, renal function, electrolytes, cardiovascular status, and nutrition) may reduce these risks and decrease mortality in patients with liver disease undergoing surgery.
肝病患者常需接受手术。随着肝病患病率的上升以及新型药物和治疗手段使生存率提高，越来越多的肝病患者需要进行术前评估。由于肝脏具有多种生理功能，肝功能障碍会使这些患者围手术期发病和死亡风险增加。与特定肝病相关的精确风险尚不清楚，但随着肝功能损害加剧风险会更高。识别出术前可得到最佳和适当处理的既往存在问题（如凝血状态、血管内容量、肾功能、电解质、心血管状态及营养状况），可能会降低这些风险，并降低接受手术的肝病患者的死亡率。
