Risk factors for posthepatectomy liver failure and related prevention and treatment methods
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摘要:
肝切除术是肝脏相关外科手术中较为常见的术式。由于其具有较高的复杂性,肝切除术后的病死率高达30%。而肝切除术后肝衰竭(PHLF)作为术后常见的并发症之一,直接影响接受肝切除术患者术后的无病生存期及总生存期。尽管在近十年来有关肝脏手术的研究与进展有了显著的发展及完善,受到患者术前的一般状态以及肝脏储备功能的影响,PHLF的发生仍然难以避免。虽然如今的技术手段可以明显减少PHLF的病死率并为患者争取到更多的机会,但如何有效的对PHLF的发生进行风险评估,并进一步指导防治策略,仍是肝脏外科医生极为关注的问题。对PHLF的相关研究进行了回顾,包括PHLF的定义、危险因素、术前评估以及PHLF的防治技术手段进展等,为减少PHLF的发生并对其进行有效的干预治疗提供参考。
Abstract:Hepatectomy is a common surgical procedure for hepatic surgeries,and due to its high complexity,the mortality rate after hepatectomy is as high as 30%. As one of the most common postoperative complications,posthepatectomy liver failure( PHLF) directly affects the disease-free survival and overall survival of patients after hepatectomy. Although there are great improvements in liver surgeries in the past ten years,PHLF cannot be avoided due to the condition and liver reserve function of patients before surgery. Although current techniques can significantly reduce the mortality rate of PHLF and bring more opportunities to patients,how to effectively evaluate the risk of PHLF and guide prevention and treatment strategies is still a major concern of liver surgeons. This article reviews the recent research on PHLF,including the definition,risk factors,preoperative evaluation,and prevention and treatment of PHLF,so as to provide a reference for reducing PHLF and performing effective treatment.
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Key words:
- hepatectomy /
- liver failure /
- risk factors /
- therapeutics
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