Analysis Of Factors Related To Severe Hepatic Dysfunction After Transcatheter Arterial Chemoembolization In Patients With Liver Cancer And The Significance Of Indocyanine Green Measurement Before TACE

Objective: To investigate the relative risk factors of severe hepatic dysfunction after transcatheter arterial chemoembolization(TACE) in patients with primary liver cancer, and evaluate ICGR15 application value in the preoperative evaluation.Methods : Collecting 109 cases of primary liver cancer after TACE in liver and gallbladder surgery from August 2011 to December 2013, retrospective analysis these cases, the relative risk factors of severe hepatic dysfunction after TACE including sex, age, surgical resection history, cirrhosis of the liver, tumor type, number of TACE, arterioportal shunting, portal vein thrombosis, Child-pugh grade, TBIL, level of ALB, AST, ICGR15 and the volume of lipiodol injected, software package was used for univariate analysis and multivariate logistic regression analysis. According to the preoperative ICGR15, the above 109 patients were divided into three groups, used the single factor analysis of variance(ANVOA) to analysis the different between three groups; Respectively count the number of patients with liver function can be compensated and decompensated after treatment. Compared the ICGR15 and Child-pugh between different groups. ICGR15 level between group by t test, liver function is compared between classification using chi-square test.Results: 1. Single variant analysis showed that cirrhosis of the liver, portal vein thrombosis,level of ALB and ICGR15 were related to severe h epatic dysfunction(P<0.05). 2. Multivariate logistic regression analysis sho wed that cirrhosis of the liver,portal vein thrombosis and ICGR15 were ri sk factors. 3. Significantly different in hepatic reserve function existed bet ween the two groups divided by Child-Pugh classification(P<0.05).4.The occurrence of hepatic dysfunction had statistical significance between three groups divided by ICGR15 test. 5. The ICGR15 test and Child-Pugh classification had statistical significance between groups divided by hepatic dysfunction after TACE.Conclusions: 1. The relative risk factors of severe hepatic dysfunctio n after TACE included cirrhosis of the liver, portal vein thrombosis and I CGR15. 2. Child-pugh classification associated with ICGR15. 3. The hepat ic reserve function in patients after TACE can be more preciselyevaluatedby ICGR15 than by Child-Pugh classification, ICGR15 test has important significance in the preoperative evaluation.