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目的：探讨肝细胞癌（HCC）患者术前总胆汁酸（TBA）水平测定的临床意义。 方法：回顾性分析176例行手术治疗的HCC患者临床资料，其中Child-PughA级173例，B级3例。分析患者术前TBA及其他相关肝功能指标判断肝硬化的敏感性，以及术前TBA水平与手术并发症的关系。结果：病理确诊为肝硬化患者88例；非肝硬化患者中，Knodell分级达S4的患者6例，全组出现手术相关并发症27例（15.3%）。与非肝硬化患者比较，肝硬化患者术前TBA水平明显升高（P0.05）；非肝硬化患者中，KnodellS4级患者术前TBA水平较S1~3级患者明显升高（均P<0.05）；术前TBA水平诊断肝硬化的ROC曲线下面积为0.685，明显大于其他指标（均P<0.05）。术前TBA水平≥10μmol/L患者手术并发症发生率明显高于TBA水平<10μmol/L患者（P<0.05）。 结论：术前TBA是评价HCC患者肝功能的敏感指标，当术前TBA≥10μmol/L，建议选择单一肝段切除或局部切除。“,”Objective:To evaluate the clinical signiifcance of determination of the preoperative level of total bile acid (TBA) in hepatocellular carcinoma (HCC) patients. Methods:hTe clinical data of 176 HCC patients undergoing surgical treatment were retrospectively analyzed. Of the patients, 173 cases had Child-Pugh A and 3 cases had Child-Pugh B liver function. hTe sensitivity of the preoperative TBA level and other liver function indexes in estimating liver cirrhosis, and the relationship between preoperative TBA level and operative complications were analyzed. in 27 patients (15.3%) in the entire group. Compared with non-cirrhotic patients, the preoperative TBA level in patients with liver cirrhosis was signiifcantly increased (P0.05), and in non-cirrhotic patients, the preoperative TBA level were signiifcantly higher in cases with Knodell stage S4 than that in those with Knodell stage S1 to S3 (all P<0.05). hTe incidence of operative complications in patients with preoperative TBA level≥10μmol/L was signiifcantly higher than in those with preoperative TBA level<10μmol/L (P<0.05). Conclusion:Preoperative TBA level is a sensitive indicator for assessing liver function in HCC patients, and in those with preoperative TBA≥10μmol/L, uni-segmental or local hepatectomy should be considered.