预测各种形式的术后急性肝衰竭。

S. V. Sin'kov, I. V. Zhilin, I. Zabolotskikh
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引用次数: 2

摘要

研究对象为2014年1月至2015年3月,年龄在18岁以上的165例患者。目的是探讨已知脏器功能障碍评分对术后肝功能衰竭的预后意义。根据临床和实验室数据、MELD量表、child - turcote - pugh量表、Maddrey量表、Schindl量表、胆汁胆汁评分、SOFA量表评估急性肝衰竭的发展情况。本文确定了手术后患者急性肝功能衰竭(肝性脑病、肝凝血功能障碍、肝肾综合征、全身血流动力学紊乱混合形式)在肝胆系统的发生率,以及术前使用a量表计算其发生概率与病情严重程度的依赖关系。基于roc分析的急性肝衰竭预测量表的计算敏感性和特异性。研究表明,对于某些形式的肝功能不全(child - turt -cotte- pugh -用于血流动力学选项和肝凝血病,MELD和SOFA量表-用于肝性脑病,SCHINDL -用于肝肾综合征和混合形式的肝功能衰竭),专业评分量表具有良好的预测准确性。所有分析的量表都对所有形式的肝衰竭具有预测价值。
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PREDICTION OF VARIOUS FORMS OF POSTOPERATIVE ACUTE LIVER FAILURE.
165 patients over 18 years in the period from January 2014 to March 2015 were studied. The aim was to investigate the prognostic significance of known scale assessment of organ dysfunction in respect ofpostoperative hepatic failure. The development of acute liver failure was assessed on the basis of clinical and laboratory data, severity of the condition by scales MELD, Child-Turcotte-Pugh, Maddrey, Schindl, BILE score, SOFA. The paper identified the incidence offorms of acute liver failure (hepatic encephalopathy, hepatic coagulopathy, hepatorenal syndrome, systemic hemodynamic disorder mixed form) in patients after surgery on hepatobiliary system, and the dependence of the probability of their occurrence on the severity of the condition, calculated using a scales in the preoperative period. Calculated sensitivity and specificity in predicting scales investigatedforms of acute liver failure based on ROC-analysis. It was shown that the specialized rating scales have good predictive accuracy in respect of certain forms of hepatic insufficiency (Child-Tur-cotte-Pugh -for hemodynamic options and hepatic coagulopathy, MELD and SOFA scales -for hepatic encephalopathy SCHINDL -for hepatorenal syndrome and mixed forms of hepatic failure). None of the analyzed scales do not possess predictive value with respect to all forms of hepatic failure.
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