半肝血流阻断下肝能量代谢变化的研究

Changes in hepatic energy metabolism during hepatopetal blood occlusion of half liver

目的 探讨全肝及半肝血流阻断时对肝脏能量代谢的影响。方法 作者对 10 5例肝细胞性肝癌行肝叶切除术的病例进行了术中动脉血酮体比率 (AKBR)连续监测。结果 发现全入肝血流阻断组复流时AKBR为 0 53± 0 10 ,半肝血流阻断组为 0 74± 0 0 6,差异有显著意义 (P <0 0 5) ,且合并有肝硬化的病例全入肝血流阻断后AKBR下降更明显达 0 42± 0 10。复流后全入肝血流阻断组AKBR回升缓慢 ,术后并发症率较高。结论 作者认为肝叶切除术时采用半肝血流阻断技术是一种简便、安全的方法 ,特别适用于原发性肝癌合并肝硬化的病例。

Objective To evaluate the changes in hepatic energy metabolism in temporary occlusion of hepatopetal blood of total or half liver.Methods Arterial blood ketone body ratio (AKBR) was measured during hepatectomy operation in 109 cases with hepatocellular carcinoma.Results It was found that the AKBR decreased to 0 53±0 10 after total hepatopetal blood occlusion (THBO). There was a statistically significant difference when compared with 0.74±0.06 in half hepatopetal blood occlusion (HHBO)(P<0.05). The AKBR decreased more evidently to 0.42±0.10 by THBO in the cases with liver cirrhosis. AKBR recovered slowly postoperatively in THBO cases with higher incidence of post operative complications.Conclusions The authors consider that HHBO is a simple method and easy to perform, especially in cases with liver cirrhosis.