规则性半肝切除的体会

Clinical effectiveness of selective total hemihepatic vascular exclusion applied to hemihepatectomy

目的探讨规则性半肝切除术的临床效果。方法比较我院2001年6月～2006年6月行规则性半肝切除的36例与同期间歇性第一肝门阻断半肝切除34例的术中平均出血量及术后肝功能等级恶化的发生率。结果规则性半肝切除组、间歇性第一肝门阻断半肝切除组术中平均出血量分别为(390±80)ml和(595±90)ml,两组间有显著性差异(P<0.01)。两组术后肝功能等级恶化发生率分别为16.6%和38.2%,有显著性差异(P<0.01)。结论规则性半肝切除显著地减少了术中的出血量和术后肝功能等级恶化的发生率。

Objective To evaluate the clinical effects of selective total hemihepatic vascular exclusion applied to hemihepatectomy. Methods From June 2001 to June 2006, the average bleeding volume in operation and hepatic function grade deterioration after operation were compared between selec- tive total hemihepatic vascular exclusion in 36 cases and interval first pedicle exclusion in 34 cases. Resuits The average bleeding volume was（390 ± 80）ml and（595 ± 90）ml in group of selective total hemihepatic vascular exclusion and that of interval first pedicle exclusion, respectively with the difference being significant between them（P〈0. 01）. The occurrence of postoperative hepatic function deterioration in two groups was 16. 6% and 38. 2%,respectively（P〈0. 01）. Conclusion Selective total hemihepatic vascular exclusion significantly reduces bleeding volume in hemihepatectomy and hepatic function grade deterioration occurrence rate after hemihepatectomy.