经腹常温下改良式全肝血流阻断无血切肝术

Modified Normothermic Hepatic Vascular Exclusion For Bloodless Transabdminal Hepatectomy

经腹常温下改良式全肝血流阻断是常温下肝血管隔离（ＮＨＶＥ）技术中创伤最小的一种术式。作者采用该技术治疗２例侵及肝右静脉、下腔静脉巨块型肝癌和１例右肝被膜下巨大血肿患者，疗效满意，并讨论其适应证、可行性、全肝热缺血时间与肝功能损害之间的关系，指出该技术是防止肝静脉出血和空气栓塞的有效措施，为切除侵及主肝静脉的肝肿瘤、修复外伤性近肝大静脉损伤提供了可靠保障，认为无肝硬化者，全肝阻断的安全时限可达３９ｍｉｎ以上，不会影响胃肠功能恢复，对有心、肺疾患者可慎重应用。

Modified normothermic hepatic auscular exclusion (NHVE) for bloodless trans -abdominal hepatectomy is a technique with least trauma. With this technique,two cases of huge liver carcinoma which invaded right hepatic vein and inferior vena cava and one case of massive subcapsular hematoma in the right hepatic lobe were treated satisfactorily. The indication, feasibility, and relation between the time of hepatic ischemia and the damage of liver function caused by operation were discussed. The authors indicated that this technique is an effective method to prevent hemorrhage due to hepatic venous injuries and air embolism, It provides reliabilities for resection of liver tumors which invaded large hepatic veins and for repair of hepatic venous injuries. The safety of whole liver vascular occlusion may be extended over 39 minutes in patients without liver cirrhosis It will not delay the recovery of gastrointestinal function And for patients with cardiac and pulmonary diseases, it can also be carefully used.