常温下半肝血流阻断与Pringle’s法的临床比较

Clinical comparison of lower half-liver blood vessel clamping with Pringle's maneuver

目的 探讨肝癌合并肝硬化病人不同肝血流阻断方法的比较及肝切除时肝血流阻断方法的选择。方法 对 6 2例HCC选用两种不同方法入肝血流阻断、癌肿的大小部位、术前及术后肝功能、术中出血量、术后引流量及其发生的并发症进行比较分析。结果 6 2例肝切除术中半肝血流阻断 30例 ,Pringle’s法 32例 ,癌肿均完整切除 ,虽然半肝血流阻断组切肝范围大 ,但术后恢复顺利 ,各项观察指标均优于Pringle’s法切肝组。结论 肝切除时肝血流阻断方法的选择应根据病变部位、切肝范围大小、肝功能及术中探查结果等综合考虑而定。选择一种合适的肝血流阻断方法是保证手术成功、术后病人顺利恢复的关健。

Objective To investigate appropriate use of hepatic blood vessel clamping during hepatectomy in patients with liver cancer complicated with liver cirrhosis. Methods Manner of blood vessel clamping,location and size of liver cancer,liver function,amount of intraoperative bleeding,postoperative drainage and complications were compared between the group using half-liver blood vessel clamping (group A,n=30) and the group using Pringle's maneuver (group B,n=32). Results The cancer was completely removed in all the 62 patients. Recovering time of liver function,amount of intraoperative bleeding,postoperative drainage and complications were significantly lower in group A than in group B. Conclusions The choice of hepatic blood vessel clamping depends on location and size of cancer,degree of liver function and cirrhosis and intraoperative exploration. Proper manner of hepatic blood vessel clamping is the key for successful operation and uneventful recovery.