原发性肝癌术前评估肝脏储备功能的应用及研究进展

刘 畅1, 樊海 宁*2
1、青海大学研究生院
2、青海大学附属医院肝胆胰外科

摘要


原发性肝癌由于其高发病率及致死率，目前仍然是一个全球性的健康挑战。对于原发性肝癌，由于肝
供体资源的稀缺，肝切除术仍然是一种首选且有效的治疗方式，但肝切除术后患者通常面临发生肝功能不全相
关并发症的风险，尽管术后肝功能不全的原因是多因素的，但肝切除术后肝衰竭（Post hepatectomy liver failure，
PHLF）已经成为围术期主要的死亡原因，影响肝癌患者的预后。肝储备功能是指肝损伤后机体维持正常功能的代
偿能力。已有研究显示肝储备功能与肝切除术后的肝衰竭（PHLF）密切相关，因此，术前评估肝功能储备对于手
术方案选择和预测肝癌患者的预后发挥越来越重要的作用。目前应用于肝脏储备功能评估的各种方法主要包括常
规血清生化检查、临床综合评分系统、肝细胞代谢排泄功能测定、功能影像学以及核素显像等。但由于目前临床
常用的肝储备功能评估方法都存在一定的局限性，无法能够准确全面的反映出肝脏的储备功能，这使得临床医师
在肝切除术前行肝脏储备功能评估时并没有完全统一的标准。本文旨在就原发性肝癌术前评估肝脏储备功能的最
新研究进展进行综述，为围术期精准评估肝储备功能，制定出安全的肝切除范围，从而降低患者 PHLF的发生率提
供科学依据和指导。

关键词


原发性肝癌；肝切除术；肝衰竭；肝脏储备功能

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