Tang Yun-Hao, Luo Yan, Wen Tian-Fu, Lu Qiang, Jiang Li, Zhu Wen-Jiang
Hepatogastroenterology. 2014 Jan-Feb;61(129):42-7.
BACKGROUND/AIMS: Low portal velocity (PV) was found in cirrhotic patients, which was thought to be a risk factor for post-hepatectomy liver failure (PHLF). This study attempted to find out whether a correlation existed between portal hemodynamics and PHLF.
From December 2010 to December 2012, all consecutive patients with Child-Pugh class A underwent liver resection were included. PV and PF were measured by using Doppler ultrasound preoperatively and on postoperative day 3. Portal hemodynamics change was explored. Univariable and multivariable analysis were used to identify risk factors for PHLF.
PHLF occurred in 25 of 151 patients, and persistent PHLF in 9 patients. Mean portal velocity change (PVmeanC) was significantly different between patients with PHLF and patients without PHLF, but it failed to be identified as independent predictor for PHLF in multivariate analysis, which found alanine aminotransferase (ALT) and Ishak score significantly associated with PHLF, and only ALT significantly associated with persistent PHLF. Subgroup analysis of the 73 cirrhotic patients also showed that none of the portal hemodynamic parameters were independent risk factors for PHLF or persistent PHLF.
None of the portal hemodynamic parameters could be used to predict PHLF or persistent PHLF.
背景/目的：肝硬化患者存在门静脉血流速度（PV）降低的情况，这被认为是肝切除术后肝衰竭（PHLF）的一个危险因素。本研究试图探究门静脉血流动力学与PHLF之间是否存在相关性。
纳入2010年12月至2012年12月期间所有连续接受肝切除的Child-Pugh A级患者。术前及术后第3天使用多普勒超声测量PV和门静脉血流量（PF）。探讨门静脉血流动力学变化。采用单因素和多因素分析来确定PHLF的危险因素。
151例患者中有25例发生PHLF，9例发生持续性PHLF。PHLF患者与未发生PHLF患者之间的平均门静脉血流速度变化（PVmeanC）存在显著差异，但在多因素分析中它未被确定为PHLF的独立预测因素，多因素分析发现丙氨酸氨基转移酶（ALT）和伊沙克评分与PHLF显著相关，且只有ALT与持续性PHLF显著相关。对73例肝硬化患者的亚组分析也表明，门静脉血流动力学参数均不是PHLF或持续性PHLF的独立危险因素。
门静脉血流动力学参数均不能用于预测PHLF或持续性PHLF。
