Novosti
Khirurgii
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Year 2010 Vol. 18 No 5

GENERAL AND SPECIAL SURGERY

DZIDZAVA I.I., KOTIV B.N., KASHKIN D.P., SMORODSKI A.V., SLOBODYANIK A.V.

THE CLEARANCE-TEST WITH INDOCIAN GREEN AS A PROGNOSTIC RISK FACTOR FOR SURVIVING IN PATIENTS WITH CIRRHOSES AND PORTAL HYPERTENSION

Objectives. To study the possibility and informational content of clearance-test with indocian green as a prognostic risk factor for surviving in the patients with cirrhoses and portal hypertension.
Methods. 189 patients with cirrhoses complicated by the portal hypertension syndrome and 30 patients without sings of liver diseases were included in the research.
Results. Plasma of disappearance rate (PDRICG) was reliably lower in the patients with cirrhoses (8,24,6%/min and 24,94,2%/min, p=0,001) and its retention rate on the 15th minute (RR15) significantly increased (34,116,5% and 6,82,3%, p=0,001). Highly reliable correlation between parameters of clearance-test and histology activity (r=-0,579, p=0,006) index, levels of bilirubin (r=-0,540, p=0,001) and albumin (r=0,447, p=0,001), protrombine time (r=0,449, p=0,001) and volume flow of the portal vein (r=0,482, p=0,001) was revealed. Indexes of test with indocianin green got worse in progress with increasing of heaviness of hepatocellular dysfunction, concordantly to the score of Child-Pugh and MELD. PDRICG had more prognostic ability if compared with these scales as in predicting one-year or five-year surviving (c- statistic 0,8130,043 and 0,8100,041). PDRICG less than 8,0%/min and RR15 more than 30,5%, with sensitivity 95% and specific character 80% were the risk factors for surviving after selective and partial portocaval shunting.
Conclusions. The definition of clearance of indocianin green is high informative and specific dynamical test, allowing to estimate the liver functional reserves and to predict survival rate in patients with cirrhoses.

Keywords: clearance-test, indocian green, liver cirrhoses, portocaval shunting
p. 37 48 of the original issue
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