第一肝门阻断与半肝血流阻断在肝切除术的比较研究

The research between the first hepatic portal control and hemihepatic vascular control in hepatectomy

目的探讨第一肝门阻断与半肝血流阻断在肝切除术中的优点与缺点,为临床行肝切除术选择血流阻断方法提供参考。方法将病人分为两组:第一肝门阻断组(Pringle,n=35)及半肝血流阻断组(HVC,n=24),比较两组病人的手术时间、术中出血量、术前及术后1、4、7天血清白蛋白、总胆红素、谷丙转氨酶(ALT)的变化,以及并发症的发生。结果 Pringle组与HVC组比较,Pringle组手术时间明显缩短(P<0.05),术后白蛋白明显低于HVC组(P<0.05),总胆红素及谷丙转氨酶明显高于HVC组(P<0.05)。结论半肝血流阻断较第一肝门阻断操作相对复杂,但肝功能损伤较轻,术后恢复快。

【Objective】 To evaluate the advantages and the disadvantages between the first hepatic portal control and hemihepatic vascular control in hepatectomy,giving the reference to the clinical working.【Methods】 The patients were devided into two groups： the first hepatic portal control group（Pringle,n=35） and hemihepatic vascular control group（HVC,n=24）,then compared with the operative duration,the intraoperative blood loss,postoperative liver function recovering and complications in the two groups.【Results】 The operative duration were significantly shorter in Pringle group than in HVC group（P0.05）.Postoperative serum albumin were remarkably lower,postoperative bilirubin and serum alaning transaminase lever were remarkly higher in Pringle group than that in HVC group（P0.05）.【Conclusion】 HVC uses a more complex technique than Pringle,but it maintains a slighter injury of liver function and a better postoperative recovery than Pringle.