半肝血流阻断在肝硬化肝癌半肝切除术中的意义

SIGNIFICANCE OF HEMIHEPATIC VASCULAR CONTROL IN HEMIHEPATECTOMY FOR HEPATOCARCINOMA PATIENTS WITH CIRRHOSIS

目的探讨半肝血流阻断在肝硬化肝癌半肝切除术中的意义。方法将26例肝癌合并肝硬化行半肝切除的病人分为半肝血流阻断组(HVC,n=14)和第一肝门阻断组(Pringle,n=12)。比较两组病人术中出血量和手术时间,术后肝功能的恢复,以及术后并发症。结果两组病人术中出血量和手术时间均无显著差异。HVC组术后3天和7天的血清谷丙转氨酶明显低于Pringle组,且下降程度也较后者明显。Pringle组有2例死于肝功能衰竭。Pringle组病人术后并发腹水显著高于HVC组。结论半肝血流阻断法比第一肝门阻断更利于术后肝功能恢复,减少手术并发症,降低死亡率。

Objective To evaluate the significance of hemihepatic vascular control in hemihepatectomy for hepatocarcinoma patients with cirrhosis. Methods Twenty-six hepatocarcinoma patients with cirrhosis underwent hemihepatectomy were divided into two groups ：Hemihepatic vascular control group（HVC ,n=14） and Pringle group （n=12）.The amount of intraoperative bleeding, time of operation, postoperative liver function, liver function recovering and complications were compared between two groups. Result There were no difference in the amount of intraoperative bleeding and time of operation between two groups. The serum alanine transaminase （ALT） of 3rd and 7th day of postoperation in HVC was significantly lower than that in Pringle group. Two patients in Pringle group died of liver function failure. Incidence of acites in Pringle group is significantly higher than in HCV. Conclusion HVC in hemihepatectomy is more suitable to those hepatocarcinoma patients with cirrhosis than Pringle maneuver.