Abstract: Objective To explore the clinical value of the ratio of standardized residual liver volume to liver hardness in predicting liver dysfunction after hepatectomy. Methods The clinical data of 61 patients who underwent hepatectomy in our hospital from January 2015 to June 2021 were analyzed retrospectively. Before operation, CT or MR were used for liver enhancement scanning, and the images were examined for three-dimensional reconstruction. Anatomical left or right hepatectomy is planned according to the location of liver tumor. The whole liver volume and the remaining liver volume were calculated according to the proposed surgical scheme. At the same time, 61 patients were examined by liver ultrasound and transient elastic imaging to detect the liver hardness value （KPA） of each patient, calculate the ratio of standardized remaining liver volume to liver hardness value （SFLV/KPA）, and observe whether 61 patients had postoperative liver insufficiency. The possible related factors causing postoperative liver insufficiency were analyzed by univariate analysis, and the factors related to postoperative liver insufficiency were obtained. Then the correlation between these factors and postoperative liver insufficiency was analyzed by binary logistic regression analysis, and the role of standardized ratio of residual liver volume to liver stiffness value （SFLV/KPA） in predicting liver insufficiency after hepatectomy was discussed. The relationship between SFLV/KPA and postoperative liver dysfunction was determined by receiver operating characteristic curve and ROC curve. Results All 61 patients were operated successfully. Seven patients had liver dysfunction, no patient had liver failure and no patient died after operation. The results of logistic regression analysis showed that intraoperative bleeding, hilar blocking time, SFLV/KPA and operation method were the influencing factors of postoperative liver dysfunction. Conclusion According to the receiver operating characteristic curve ROC curve, when the ratio of SFLV/KPA （standardized residual liver volume/liver hardness） is greater than 30.6, patients generally do not have liver dysfunction after operation, and the operation safety is higher.

Key words: standardized residual liver volume, liver hardness value, hepatectomy, liver dysfunction

摘要： 目的 探讨应用标准化剩余肝体积与肝硬度值的比值预测肝脏切除术后肝功能不全的临床价值。方法 回顾性分析我院2015年1月~2021年6月行肝脏切除术患者61例的临床资料,术前采用CT或者MR进行肝脏增强扫描,检查图像进行三维重建。按照肝脏肿瘤的位置拟行解剖性左半肝脏或者右半肝脏切除术。并按照拟定的手术方案计算出全肝体积及剩余的肝脏体积,同时对61位患者行肝脏超声影像和瞬时弹性成像检查,检测出每位患者的肝脏硬度值（KPA）,计算出标准化剩余肝体积与肝硬度值的比值（SFLV/KPA）,并观测61位患者是否出现术后肝功能不全。把引起术后肝功能不全的可能相关因素进行单因素分析,得到与术后肝功能不全相关的影响因素,再通过二元logistics回归分析分析这些因素与术后肝功能不全的相关性,探讨标准化剩余肝体积与肝硬度值的比值（SFLV/KPA）预测肝脏切除术后肝功能不全的作用。并通过受试者工作特征曲线ROC曲线确定SFLV/KPA与术后肝功能不全的关系。结果 61例患者手术全部成功,术后有7例患者出现肝功能不全,无患者出现肝功能衰竭,无患者术后死亡。研究显示术中出血量、肝门阻断时间、SFLV/KPA、手术方式均是术后肝功能不全的影响因素。结论 通过受试者工作特征曲线ROC曲线,SFLV/KPA（标准化剩余肝体积/肝脏硬度值）比值大于30.6时,患者术后一般不出现肝功能不全,手术安全性更高。

关键词: 标准化剩余肝体积, 肝硬度值, 肝脏切除术, 肝功能不全