肝段门静脉球囊导管阻断联合区域性肝动脉阻断在肝癌肝切除术的应用

Combined selective portal venous balloon catheter occlusion and regional hepatic artery occlusion in hepatectomy of hepatocellular carcinoma

目的探讨肝段门静脉球囊导管阻断联合区域性肝动脉阻断下的肝切除术治疗肝细胞癌的临床应用效果。方法 2007年7月至2010年6月南昌大学第二附属医院对48例肝细胞癌病人行应用肝段门静脉球囊导管阻断联合区域性肝动脉阻断下的肝切除术(A组),同时将应用常规肝切除术70例病人分为Pringle法阻断组(B组,n=36)和肝门区域性血管阻断组(C组,n=34),比较三组的手术时间、术中出血量和术后肝功能指标。结果三组病人均无手术死亡。A组手术时间较C组短,A组与B组比较差异无统计学意义;A组术中出血量少于C组,A组与B组比较差异无统计学意义;A组术后肝功能恢复较B组快,A组与C组比较差异无统计学意义。结论肝段门静脉球囊导管阻断联合区域性肝动脉阻断下的肝切除术是安全有效的手术方式,对于有适应证的肝细胞癌病人,采用此术式可获得较好的疗效。

Objective To evaluate the therapeutic effect of hepatectomy under selective portal venous balloon catheter occlusion and regional hepatic artery occlusion for hepatocellular carcinoma. Methods Forty-eight cases （group A） of hepatocellular carcinoma were performed bepatectomy under selective portal venous balloon catheter occlusion and regional hepatic artei7 occlusion between July 2007 and June 2010 at the Second Affiliated Hospital of Nanchang University. Seventy cases （36 cases of Pringle occlusion named group B＋34 cases of regional hepatic artery occlusion named group C） were performed traditional hepatectomy. The mean operation time, estimated operative blood loss and postoperative liver function among three groups were compared. Results There was no operative mortality in three groups. The mean operation time in group A was shorter than that in group C. There was no significant statistical difference between group A and group B. The estimated operative blood loss in group A was less than that in group C. There was no significant statistical difference between group A and that in group B. The recovery of postoperative liver function in group A was faster than that in group B. There was no significant statistical difterence between group A and group C. Conclusion Hepatectomy under selective portal venous balloon catheter occlusion and regional hepatic artery occlusion is safe and effective, which is suitable for the hepatocellular carcinoma patients with operative indication.