肝脏手术难度大、风险高，临床上具有一定的并发症及术后死亡率。特别对于肝硬化或者严重肝功能损伤的病人，积极的肝脏功能评估是必要的。目前临床上对肝脏功能的评估方式主要有常规血清学肝功能检查、定量肝功能检测、临床综合评分系统、肝脏体积测定等。常规血清学肝功能检查主要是通过测定血液中可以直接或间接反映肝脏合成、代谢、凝血等功能的指标，来实时监测肝脏功能的变化。定量肝功能检测主要是ICG试验，由于能很好地反映肝脏对手术的耐受能力，渐渐成为肝脏术前的常规检查。Child-pugh分级和MELD评分是肝脏外科中十分重要和得到普遍认可的评分系统，对于肝脏手术病人及手术时机的选择具有重要价值。而肝脏体积是直接反映肝脏细胞数量的指标，肝脏术后足够的残余肝脏体积对于预防肝衰的发生有着极为重要的作用，目前临床上测量肝脏体积的方法主要是标准肝体积公式及影像学相关的测量方法。利用以上方法综合、全面地评估肝脏功能，可以帮助外科医师决定肝脏的可切除性及可切除范围，同时制定手术方案，尽可能避免肝衰及术后死亡的发生。总而言之，围手术期肝脏功能评估对于肝脏手术的安全性及手术方案的设计具有十分重要的作用。

[1] 徐捷,黄炳新.肝炎肝硬化患者的肝功能检验结果分析[J].现代医学,2009,37(6):437-439.
[2] LAU H,MAN K,FAN S T,et al.Evaluation of preoperation hepatic function in patients with hepatocellular carcinoma undergoing hepatectomy[J].Br J Surg,1997,84(9):1255-1259.
[3] 山际健太郎,川原田嘉文.肝障碍の评价と手术安全性の预测[J].日本外科学杂志,1997,98(8):658-662.
[4] SAKKA S G,REINHART K,MEIER-HELLMANN A.Prognostic value of the indocyanine green plasma disapparance rate in critically ill patients[J].Chest,2002,122(5):1715-1720.
[5] FAN S T,LAI E C,LO C M,et al.Hospital mortality of major hepatectomy for hepatocellular carcinoma associated with cirrhosis[J].Arch Surg,1995,130:198-203.
[6] LAM C M,FAN S T,LO CM,et al.Major hepatectomy for hepatocellular carcinoma in patients with an unsatisfactory indocyanine green clearance test[J].Br J Surg,1999,86:1012-1017.
[7] YAMAZAKI S,TAKAYAMA T.Surgical treatment of hepatocellular carcinoma:evidence-based outcomes[J].World J Gastroenterol,2008,14:685-692.
[8] FAN S T.Liver functional reserve estimation:state of the art and relevance for local treatments:the Eastern perspective[J].J Hepatobiliary Pancreat Sci,2010,17:380-384.
[9] 劳向明,张亚奇,林小军,等.吲哚靛青绿潴留率判断切肝量及肝癌术后肝功能不全的关系[J].癌症,2005,24(3):337-340.
[10] de LIGUORI CARINO N,O' REILLY D A,DAJANI K,et al.Perioperative use of the LiMON method of indocyanine green elimination measurement for the prediction and early detection of post-hepatectomy liver failure[J].EUR J Surg Oncol,2009,35:957-962.
[11] 黎一鸣,吕凡,吉鸿,等.肝脏体积变化与病肝储备功能的关系研究[J].中华普通外科杂志,2003,18(2):79-81.
[12] TEH S H,CHRISTEIN J,DONOHUE J,et al.Hepatic resection of hepatocellular carcinoma in patients with cirrhosis:Model of End-Stage Liver Disease (MELD) score predicts perioperative mortality[J].J Gastrointest Surg,2005,9:1207-1215.
[13] DELIS S G,BAKOYIANNIS A,DERVENIS C,et al.Perioperative risk assessment for hepatocellular carcinoma by using the MELD score[J].J Gastrointest Surg,2009,13:2268-2275.
[14] URATA K,KAWASAKI S,MATSUNAMI H,et al.Calculation of child and adult standard liver volume for liver transplantation[J].Hepatology,1995,21:1317-1321.
[15] HEINEMANN A,WISCHHUSEN F,PUSCHEL K,et al.Standard liver volume in the Caucasian population[J].Liver Transpl Surg,1999,5:366-368.
[16] VAUTHEY J N,ABDALLA E K,DOHERTY D A,et al.Body surface area and body weight predict total liver volume in Western adults[J].Liver Transpl,2002,8:233-240.
[17] 周才明,吕明德,殷晓煜.肝纤维化定量评估肝癌病人肝功能储备力的临床研究[J].中华肝胆外科杂志,2004,10:583-585.
[18] 黄黎香,丁恩慈,沈文,等.MSCT、IQQA评价肝移植供体术前肝体积的价值[J].中国医学影像技术,2012,28(4):783-786.
[19] 魏林,蒋文涛,高伟,等.活体肝移植中IQQA法与手工描记法对供肝体积评估的比较研究[J].中华器官移植杂志,2012,33(6):351-353.
[20] KOKUDO N,VERA D R,TADA K,et al.Predictors of successful hepatic resection:prognostic usefulness of hepatic asialoglycoprotein receptor analysis[J].World J Surg,2002,26(11):1342-1347.
[21] 戴朝六,夏振龙.肝癌肝切除术后肝功能不全的防护[J].中国实用外科杂志,1999,19(6):327-329.
[22] DAI C L,HUAI M S,ZHU X,et al.Risk factor for postoperative complication after hepatic resection in patients with the hepatocellular carcinoma[J].J Jpn Surg Assoc,2001,62(suppl):352.
[23] 范毓东,周代全,王成波,等.肝脏外科中的虚拟手术方案设计[J].消化外科,2005,4(5):336-340.