标准化残肝体积预测泡型肝包虫病患者术后发生肝功能不全的研究

发布时间：2018-03-19 08:52

本文选题：泡型肝包虫病　切入点：三维重建　出处：《青海大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探索标准化残肝体积在预测肝泡型包虫病患者行手术治疗后发生肝功能不全中的作用。方法:(1)研究对象:收集青海大学附属医院肝胆胰外科2014.11—2016.01期间行半肝切除的泡型肝包虫病患者临床资料;(2)三维重建:对患者薄层CT资料通过IQQA-LIver软件行肝脏三维重建。(3)统计分析:统计软件采用SPSS17.0,对分类变量采用两独立样本的t检验,对分类变量采用χ2检验,多因素分析,ROC曲线预测最佳值。结果:(1)收集2014.11—2016.01期间263例行手术的泡型肝包虫患者临床资料,经筛选符合纳入排除标准的为39例。(2)经单因素分析标准化残肝体积是术后发生肝功能不全的影响因素,多因素分析提示标准化残肝体积是术后肝功能不全的独立的影响因素。(3)ROC曲线分析结果提示:当标准化残肝体积为365.14ml/m2时,此时的灵敏度与特异度之和最大。结论:(1)通过本研究发现SRLV与HAE患者术后发生肝功能不全密切相关,是独立的影响因素。(2)通过进一步分析我们得到SRLV最佳临界值为365.14ml/m2,当SRLV为小于365.14ml/m2时,术后发生PLD的风险明显增加;同时该临界值为HAE患者行术前残肝体积评估提供一个量化参考指标。
[Abstract]:Objective: to explore the role of standardized residual liver volume in predicting hepatic dysfunction in patients with hepatic alveolar hydatidosis after surgical treatment. Three-dimensional reconstruction of resected patients with hepatic hydatid disease: the thin slice CT data of the patients were analyzed by IQQA-LIver software. SPSS 17.0 was used, and two independent samples were used to test the classification variables. 蠂 2 test and multivariate analysis were used to predict the best value of ROC curve. Results the clinical data of 263 patients with hepatic hydatid disease undergoing operation were collected from January 11 to January 2016.The clinical data of 263 patients with hepatic hydatid disease were analyzed. 39 patients who met the exclusion criteria were screened. The standardized residual liver volume was analyzed by single factor analysis as the influencing factor of postoperative liver insufficiency. Multivariate analysis showed that standardized residual liver volume was an independent influencing factor of postoperative liver insufficiency. The results of ROC curve analysis showed that: when standardized residual liver volume was 365.14 ml / m ~ 2, At this time, the sum of sensitivity and specificity is the largest. Conclusion: through this study, we found that SRLV is closely related to postoperative liver insufficiency in patients with HAE. By further analysis, we obtained that the best critical value of SRLV is 365.14 ml / m ~ 2. When SRLV is less than 365.14 ml / m ~ 2, the risk of PLD after operation is significantly increased. At the same time, this critical value provides a quantitative reference index for preoperative assessment of residual liver volume in patients with HAE.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.3

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