摘要
目的探讨预先区域性血流阻断在肝脏肿瘤切除术中的作用。方法28例肝肿瘤患者采用预先区域性血流阻断技术行肿瘤切除(阻断组),24例采用常规肝肿瘤切除患者(对照组)。术前两组患者肝功能Child-Pugh评分均为A级。阻断组术中采用血流阻断针在B超配合下将阻断带置入肿瘤周围肝实质中阻断肿瘤的血流,对照组采用第一肝门阻断法切除肿瘤。结果阻断组出血量、麻醉时间及术后住院天数分别为(340±92)ml,(98.4±25.0)min,(10.2±2.3)d;对照组为(620±124)m1,(135.8±47.5)min,(16.5±5.1)d,两组比较差异有统计学意义(分别t=9.222,9.328,5.875,均P〈0.01)。术后第2天阻断组和对照组ALT分别为(378.4±35.2)U/L,(539.2±115)U/L(t=7.012,P〈0.01),TBIL(37.5±11.2)mmol/L,(51.8±29)mmol/L(t=8.818,P〈0.01),阿(17.4±2.4)sec,(20.4±2.8)sec(t=4.16,P〈0.01)。术后第7天阻断组和对照组ALT分另0为(57.1±15.5)U/L,(98.1±21.2)U/L,TBIL(25.4±4)mmol/L,(46.3±13)mmol/L,PT(13.2±4.2)sec,(15.7±2.2)sec,两组相比差异有统计学意义(分别t=8.039,8.085,2.621,均P〈0.01)。结论预先区域性肝血流阻断术能较好控制肝癌术中出血有利于术后肝功能恢复。
Objective To evaluate regional blood flow occlusion (RBFO) in hepatectomy for liver neoplasms. Methods In this study, hepatic tumors were resected under RBFO in 28 cases (RBFO group) , and under Springle's technique(control group) in 24 cases. The Child-Pugh classifications of liver function were grade A in all patients. The ligature ribbon was put in liver parenchyma around tumor to block the blood supply before resecting the tumor under guiding of B sounography in RBFO group. Anesthesia time, blood loss and transfusion, hospitalization, change of liver function and complications were compared between the two groups. Results Blood loss, anesthesia time and postoperative hospital stay were (340 ± 92) ml, (98.4 ±25. 0) min, (10.2 ±2. 3) d in RBFO group and (620±124) ml, (135. 8 ±47.5) min, (16. 5 ± 5.1 ) d, respectively, in control group, differences were all significant between the two groups (P 〈 0. 01, t = 9. 222, 9. 328 and 5. 875, respectively). On post-op day 2, ALT (U/L) was ( 378.4 ± 35.2) vs. (539.2±115.4) (t=7.012, P〈0.01), TBIL (37.5 ±11.2) vs. (51.8 ±29) mmol/L(t= 8.818, P〈0.01),PT (17.4±2.4) vs. (20.4 ±2.8) sec(t =4.16, P〈0.01) in RBFO group and control group, respectively. ALT was (57.1 ± 15.5 ) vs. (98.1 ± 21.2 ) U/L ( t = 8. 039 ), TBIL ( 25.4 ± 4) vs. (46.3±13) mmol/L(t=8.085),PT (13.2±4.2) vs. (15.7±2.2) sec (t=2.621)onpost-op day 7 respectively, again the differences were all significant betweet the two groups (all P 〈 0. 01 ). Conclusion Regional blood flow occlusion is an effective technique to control blood loss during hepatectomy for liver neoplasms.
出处
《中华普通外科杂志》
CSCD
北大核心
2008年第6期432-434,共3页
Chinese Journal of General Surgery
关键词
肝肿瘤
肝切除术
出血
选择性血流阻断
Liver neoplasms
Hepatectomy
Hemorrhage
Selective blood flow occlusion