The Clinic Value Of The Indocyanine Green Excretion Test In The Assessment Of Patients With Cirrhosis Of Hepatic Functional Reserve And Its Correlation

Objective:Retrospective study to compare indocyanine green (ICG) excretion test (DDG)and Child-Pugh classification, correlation and evaluation of the clinical routine serumchemistry test indicators of liver function reserve; analysis of indocyanine greenexcretion test for assessing preoperative hepatic functional reserve in patients withcirrhosis and complications of value and its relevanceMethod:Collected from November2010to May2011, First Affiliated Hospital ofNanchang University, Department of General Surgery Hepatobiliary PancreaticDiseases, a total of53cases,35cases of male patients,18cases of female patients,aged26-76years old, average (52.24±13.90) years old.of whom47underwentsurgical treatment, and another six cases of transfer due to their own and othermedical treatment or give up surgery. All patients routine liver function, coagulation,serum biochemical tests and abdominal B ultrasound, upper abdominal CT imagingaccordance with the Child-Pugh score classification, each patient underwent ICG test(DDG).1、All of the subjects according to Child-Pugh classification to group, thedifference between the group of the group K value (ICG plasma clearance rate) andICGRl5(ICGl5min retention rate), to explore the ICG test and Child-Pughclassification.2、the grouped by ICGRl5value, comparing different ICGR15correlation withpreoperative serum TBIL, ALT and AST, ALB,, the PT test results to explore theICG test and serum chemistry tests, the relationship between its significance.3、the value of grouping the ICGR15and K, were compared between groupspreoperative diagnosis of cirrhosis of the liver with ICG test; compare the cirrhosisgroup ICGR15positive rate of ICG test in the diagnosis of cirrhosis of the value andpredictive. 4、Again ICGRl5value into ICGR15<10%and ICGR15of≥10%group,comparison between the two groups of postoperative hepatic dysfunction incidence.Study the ICG test and postoperative complications and the guidance of significance.Results:1、53cases of patients in the Child A,37cases, the Child B,14cases, the ChildC,2cases (too few, not included in statistics). Child group A ICGRl5(10.03±8.67)%, K value (0.17±0.05)/min; Child B the group ICGRl5(22.34±10.73)%, Kvalue (0.10±0.04)/min.; Two groups ICGRl5difference significance (P=0.001),K value difference was significant (P=0.001).2、ICGR15and TBIL、ALB、PT were significantly correlated (P <0.05) afteradjustment for age and gender, is still statistically significant (P <0.05). The ICGR15high-value group compared with ICGR15low group, patients TBIL value increasedprolonged PT values, ALB, levels. The ICGR15、ALT、AST does not have acorrelation (P>0.05).3、53cases of patients in31cases with different degrees of cirrhosis of the liver,accounting for58.4%;22patients without cirrhosis, accounting for41.6%. Patientswith cirrhosis ICGRl5(21.31±9.68)%, K value (0.11±0.04)/min. Non-cirrhoticpatients ICGRl5mean (8.83±10.06)%, K value (0.18±0.05)/min. The two groupsICGRl5the difference was significant (P=0.001), K value of the difference wassignificant (P=0.000). Compare different degrees of cirrhosis patients ICGR15≥10%detection rate, absence of cirrhosis was detected in13.63%(3/22), decompensatedcirrhosis detection rate of87.10%(23/27). Decompensated liver cirrhosis detectionrate of100%(4/4)4、ICGR15<10%group (ICG test negative) and ICGR15≥10%group (ICG testpositive),the incidence of postoperative liver dysfunction were9.52%(2/21)、26.92%(7/26). Two groups was statistically significant (P<0.05).Conclusion:1、the ICG excretion test is accurate, sensitive response to liver hepatic reserve,the detection ICGRl5and K values with good correlation, with Child-Pughclassification as supplement.2、ICGRl5with serum TBIL、ALB and PT has a significant correlation. ICGR15 patients with elevated TBIL elevated PT value extension of the ALB levels.3、the preoperative diagnosis of liver cirrhosis in patients with ICG test resultsobvious cirrhosis compared with patients without cirrhosis ICGRl5value wassignificantly higher, while the K value is significantly lower. ICG test in preoperativediagnosis of cirrhosis is very sensitive. Tip in patients with cirrhosis line ICG test.4、ICGR15indicators of liver function failure was significantly associatedICGR15the higher the postoperative liver dysfunction in the higher incidence,indicating that the ICG excretion test to predict postoperative complications guidance.