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腹腔镜检查对肝病的诊断极为重要。由于普通腹腔镜检查的局限性,特将靛氰绿(ICG)大量静注后的腹腔镜检查应用于临床。本文分析了临床病例肝表面ICG 着色不良原因及组织所见,并用动物肝病变模型对比分析着色不均匀情况以及严重肝损害、肝功不全时的着色状况。作者对118例(急性肝炎5例、慢性肝炎40例、肝硬化32例、肝细胞癌11例、肝纤维化9例、脂肪肝6例、原发性胆汁肝硬化5例、转移性肝肿瘤4例、肝血管瘤3例、Gilbert 综合征1例、特发性门脉高压症1例)进行腹腔镜检查,然后大量静注ICG。将ICG250mg(64例)或4mg/kg(54例)溶解在蒸馏水20ml中,肘静脉穿刺,与自家血充分混合后,约3分钟静注。静注后30分钟观察肝表面,每分钟拍片记录进行比较。整个肝表面高度着色为良,中度着色为稍好,轻度着色为不良。
Laparoscopy is extremely important for the diagnosis of liver disease. Due to the limitations of general laparoscopy, a large number of intravenous indocyanine green (ICG) laparoscopy after clinical application. In this paper, we analyzed the causes and histological findings of ICG coloration on the liver surface of clinical cases, and compared the pigmentation inhomogeneity, severe liver damage and hepatic insufficiency with animal liver lesion model. The authors of 118 cases (acute hepatitis in 5 cases, 40 cases of chronic hepatitis, 32 cases of cirrhosis, hepatocellular carcinoma in 11 cases, 9 cases of liver fibrosis, fatty liver in 6 cases, 5 cases of primary biliary cirrhosis, metastatic liver tumors 4 cases, 3 cases of hepatic hemangioma, 1 case of Gilbert’s syndrome, 1 case of idiopathic portal hypertension) and then a large amount of intravenous injection of ICG. Dissolve ICG250mg (64 cases) or 4mg / kg (54 cases) in 20ml of distilled water. The cubital vein puncture and mix well with your own blood and intravenously about 3 minutes. Observed 30 minutes after intravenous injection of liver surface, filming records per minute for comparison. Highly colored throughout the liver surface is good, moderately colored is slightly better, mildly colored is bad.